Isomerism is not Associated with Thrombocytosis or Thromboembolic Events in Adulthood: Results from a National Database Study

Rohit S Loomba, Saurabh Aggarwal, Matthew Buelow, Yingot Arora and Rohit R Arora

Background: So-called heterotaxy, better called bodily isomerism, is associated with increased frequency of thrombocytosis and thromboembolic events in childhood. This is likely mediated by splenic dysfunction present with isomerism. Data for adults with isomerism is lacking with a paucity of data regarding thrombosis and isomerism. This study aimed to determine the risk of thrombocytosis and thromboembolic events in adults with isomerism.
Methods: The 2012 iteration of the Nationwide Inpatient Sample was used. International classification of disease codes were used to identify admissions associated with isomerism, thrombocytosis, and thromboembolic events. Chi-square analysis was conducted to determine factors associated with thrombocytosis and various thromboembolic events. Logistic regression was used to estimate the adjusted odds ratio of isomerism.
Results: A total of 6,907,109 admissions were included, 861 of which had isomerism. Thrombocytosis was equally prevalent in those with and without isomerism with a frequency of 0.1%. Acute thromboembolic events were equally prevalent in both groups as well, with lower extremity thromboembolic events being most prevalent in both. Older age and male gender were both independent risk factors for thromboembolic events but not isomerism.
Conclusion: Thrombocytosis and acute thromboembolic events are not more common in those with isomerism. They do, however, occur at a younger in those with isomerism and are associated with increased length and cost of hospitalization.