J Vasc Surg Venous Lymphat Disord. 2023 Mar 7:S2213-333X(23)00062-8. doi: 10.1016/j.jvsv.2023.02.001. Online ahead of print.
OBJECTIVE: The mainstay of therapy for patients with venous thromboembolic disease (VTE) is anticoagulation. In the inpatient setting, majority of these patients are treated with heparin or low molecular weight heparin. The prevalence and outcomes of heparin induced thrombocytopenia (HIT) in hospitalized patients with venous thromboembolic disease (VTE) is unknown.
METHODS: This nationwide study identified patients with VTE from the National Inpatient Sample (NIS) database between January 2009 and December 2013. Amongst these patients, we compared in-hospital outcomes of patients with and without HIT using a propensity score-matching algorithm. Primary outcome was in-hospital mortality. Secondary outcomes included rates of blood transfusions, intracranial hemorrhage (ICH), gastrointestinal (GI) bleed, length of hospital stay (LOS), and total hospital charges.
RESULTS: Amongst 791,932 hospitalized patients with VTE, 4,948 (0.6%) patients were noted to have HIT (mean age 62.9 ±16.2 yrs and 50.1% female). Propensity matched comparison showed higher rates of in-hospital mortality (11.01% vs. 8.97% p<.001) and blood transfusions (27.20% vs. 20.23% p<0.001) in HIT patients compared to those without HIT. No significant differences were noted in ICH rates (0.71% vs. 0.51% p>0.05), GI bleed (2.00% vs. 2.22% p >0.05), LOS (median 6.0 days IQR (3.0 - 11.0) vs. 6.0 days (3.0 - 10.0) p>0.05), and total hospital charges (median $36,325 IQR ($17,798 - $80,907) vs. $34,808 ($17,654 - $75,624) p >0.05).
CONCLUSION: This nationwide observational study showed that 0.6% of hospitalized VTE patients in the United States have HIT. Presence of HIT was associated with higher in-hospital mortality and blood transfusion rates compared to those without HIT.
PMID:36893884 | DOI:10.1016/j.jvsv.2023.02.001