PMID- 12480713
OWN - NLM
STAT- MEDLINE
DCOM- 20030618
LR  - 20220408
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 101
IP  - 8
DP  - 2003 Apr 15
TI  - The incidence of heparin-induced thrombocytopenia in hospitalized medical 
      patients treated with subcutaneous unfractionated heparin: a prospective cohort 
      study.
PG  - 2955-9
AB  - 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.
FAU - Girolami, Bruno
AU  - Girolami B
AD  - Division of Internal Medicine, Department of Medical and Surgical Sciences, 2nd 
      Chair of Internal Medicine, University Hospital of Padua, Italy.
FAU - Prandoni, Paolo
AU  - Prandoni P
FAU - Stefani, Piero M
AU  - Stefani PM
FAU - Tanduo, Cinzia
AU  - Tanduo C
FAU - Sabbion, Paola
AU  - Sabbion P
FAU - Eichler, Petra
AU  - Eichler P
FAU - Ramon, Roberto
AU  - Ramon R
FAU - Baggio, Giovannella
AU  - Baggio G
FAU - Fabris, Fabrizio
AU  - Fabris F
FAU - Girolami, Antonio
AU  - Girolami A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20021212
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Anticoagulants)
RN  - 37270-94-3 (Platelet Factor 4)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*adverse effects/immunology
MH  - Autoimmune Diseases/chemically induced/*epidemiology/immunology
MH  - Cohort Studies
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Follow-Up Studies
MH  - Heparin/administration & dosage/*adverse effects/immunology
MH  - Hospital Departments/statistics & numerical data
MH  - Hospitals, University/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Injections, Subcutaneous
MH  - Inpatients
MH  - Internal Medicine
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Platelet Factor 4/immunology/metabolism
MH  - Prevalence
MH  - Prospective Studies
MH  - Thrombocytopenia/chemically induced/*epidemiology/immunology
MH  - Thromboembolism/epidemiology/prevention & control
EDAT- 2002/12/14 04:00
MHDA- 2003/06/19 05:00
CRDT- 2002/12/14 04:00
PHST- 2002/12/14 04:00 [pubmed]
PHST- 2003/06/19 05:00 [medline]
PHST- 2002/12/14 04:00 [entrez]
AID - S0006-4971(20)50785-4 [pii]
AID - 10.1182/blood-2002-07-2201 [doi]
PST - ppublish
SO  - Blood. 2003 Apr 15;101(8):2955-9. doi: 10.1182/blood-2002-07-2201. Epub 2002 Dec 
      12.