Back to Search
Start Over
The incidence of heparin-induced thrombocytopenia in hospitalized medical patients treated with subcutaneous unfractionated heparin: a prospective cohort study
- Source :
- Blood. 101:2955-2959
- Publication Year :
- 2003
- Publisher :
- American Society of Hematology, 2003.
-
Abstract
- Although heparin-induced thrombocytopenia (HIT) is a known complication of intravenous unfractionated heparin (UFH), its incidence in medical patients treated with subcutaneous UFH is less well defined. To determine the incidence of HIT in this category of patients, the platelet count was performed at baseline and then every 3 ± 1 days in 598 consecutive patients admitted to 2 medical wards and treated with subcutaneous UFH for prophylactic (n = 360) or therapeutic (n = 238) indications. The diagnosis of HIT was accepted in the case of a platelet drop of 50% or more and either the demonstration of heparin-dependent antibodies or (when this search could not be performed) the combination of the following features: (1) the absence of any other obvious clinical explanation for thrombocytopenia, (2) the occurrence of thrombocytopenia at least 5 days after heparin start, and (3) either the normalization of the platelet count within 10 days after heparin discontinuation or the earlier patient's death due to an unexpected thromboembolic complication. HIT developed in 5 patients (0.8%; 95% CI, 0.1%-1.6%); all of them belonged to the subgroup of patients who received heparin for prophylactic indications. The prevalence of thromboembolic complications in patients with HIT (60%) was remarkably higher than that observed in the remaining 593 patients (3.5%), leading to an odds ratio of 40.8 (95% CI, 5.2-162.8). Although the frequency of HIT in hospitalized medical patients treated with subcutaneous heparin is lower than that observed in other clinical settings, this complication is associated with a similarly high rate of thromboembolic events.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
medicine.drug_class
Injections, Subcutaneous
Immunology
Hospital Departments
Platelet Factor 4
Biochemistry
Autoimmune Diseases
Cohort Studies
Hospitals, University
Thromboembolism
Internal medicine
Heparin-induced thrombocytopenia
Internal Medicine
Prevalence
medicine
Humans
Prospective Studies
Prospective cohort study
Aged
Aged, 80 and over
Inpatients
Dose-Response Relationship, Drug
Heparin
business.industry
Incidence
Incidence (epidemiology)
Anticoagulant
Anticoagulants
Cell Biology
Hematology
Middle Aged
medicine.disease
Thrombocytopenia
Discontinuation
Surgery
Italy
Female
business
Complication
Platelet factor 4
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 15280020 and 00064971
- Volume :
- 101
- Database :
- OpenAIRE
- Journal :
- Blood
- Accession number :
- edsair.doi.dedup.....8437382ce5fb9219e32b621a415fe1d2