Heparin-Induced Thrombocytopenia Outcomes Are Often Poor

Rates of complication in patients with heparin-induced thrombocytopenia (HIT) are high, suggesting the need for more effective preventive and treatment interventions, according to the results of a recent study.

Despite previous research estimating incidence and complication rates of HIT and the availability of therapeutic interventions, outcomes of HIT are still not well understood.
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To further explore this issue, researchers conducted a population-based study in which they analyzed data from the 2009 to 2013 Nationwide Inpatient Sample, a large, all-payer inpatient healthcare database in the US. Primary outcomes included the incidence of hospital discharges with codes for HIT and HIT associated with cardiopulmonary bypass, hemodialysis, hip or knee arthroplasty, trauma or injury, and gingival or periodontal disease. The incidence of thrombosis, bleeding, limb or digit amputation, mortality, and length of hospital stay were also assessed.

Overall, 97,566 discharges assigned the ICD-9-CM code for HIT and 149,911,247 discharges coded for non-heparin-induced thrombocytopenia were analyzed. Patients undergoing cardiopulmonary bypass had the highest rates of HIT, followed by those undergoing hemodialysis, those with gingival or periodontal disease, or both, and those with trauma or injury, and those with hip and knee arthroplasty had the lowest rates of HIT.

Thrombosis and bleeding were common in patients with HIT, and 1446 of 6044 of those with HIT who had hemorrhage died. Amputations were performed in 97,566 patients with HIT compared with 173,043 of 149,911,247 with non-heparin-induced thrombocytopenia. In-hospital mortality occurred in 9842 of 97,508 patients with HIT compared with 3,206,700 of 149,811,891 patients with non-heparin-induced thrombocytopenia.

“Complication rates for heparin-induced thrombocytopenia remain high and more effective preventive and treatment interventions are needed,” the researchers concluded.

—Michael Potts

Reference:

Dhakal B, Kreuziger LB, Rein L, et al. Disease burden, complication rates, and health-care costs of heparin-induced thrombocytopenia in the USA: a population-based study. Lancet Haematology. 2018;5(5):220-231.