PMID- 16999654
OWN - NLM
STAT- MEDLINE
DCOM- 20070222
LR  - 20220318
IS  - 0277-0008 (Print)
IS  - 0277-0008 (Linking)
VI  - 26
IP  - 10
DP  - 2006 Oct
TI  - Incidence and economic implications of heparin-induced thrombocytopenia in 
      medical patients receiving prophylaxis for venous thromboembolism.
PG  - 1438-45
AB  - STUDY OBJECTIVES: To determine the incidence of heparin-induced thrombocytopenia 
      (HIT) in patients admitted to a medical service who were given unfractionated 
      heparin (UFH) or low-molecular-weight heparin (LMWH) to prevent venous 
      thromboembolism, the incremental cost of developing HIT, and the cost 
      consequences of using LMWH to prevent venous thromboembolism in medical patients. 
      DESIGN: Retrospective analysis with a nested case-control. SETTING: 
      University-affiliated tertiary-care hospital. PATIENTS: A total of 10,121 adult 
      medical patients admitted between August 1, 2000, and November 2, 2004, received 
      UFH or LMWH to prevent venous thromboembolism during their admission. From these, 
      patients with immune-mediated HIT were identified and served as case patients, 
      and 3-5 matched control patients were identified for each case patient. 
      MEASUREMENTS AND MAIN RESULTS: The development of HIT was determined for patients 
      who received LMWH and for patients who received UFH. Costs were compared between 
      the patients with HIT and the matched control patients. The cost of using LMWH to 
      prevent venous thromboembolism was compared with the cost of using UFH. In 
      patients receiving UFH and those receiving LMWH, the incidence of HIT was 0.51% 
      (43/8420) and 0.084% (1/1189), respectively (p=0.037), with an overall incidence 
      of 0.43% (44/10,121). Admissions that included development of HIT incurred an 
      average cost of 56,364 dollars compared with 15,231 dollars (p<0.001) for 
      admissions without HIT. Using LMWH to prevent venous thromboembolism in medical 
      patients cost 13.88 dollars less per patient than using UFH. CONCLUSIONS: For the 
      prophylaxis of venous thromboembolism, LMWH was associated with a lower incidence 
      of HIT than UFH in medical patients. An admission during which the patient 
      develops HIT costs significantly more than an admission during which the patient 
      does not develop HIT. Low-molecular-weight heparin is cost-effective for 
      prevention of venous thromboembolism in medical patients.
FAU - Creekmore, Freddy M
AU  - Creekmore FM
AD  - College of Pharmacy, University of Utah, Salt Lake City, Utah 84112, 
      fcreekmore@pharm.utah.edu
FAU - Oderda, Gary M
AU  - Oderda GM
FAU - Pendleton, Robert C
AU  - Pendleton RC
FAU - Brixner, Diana I
AU  - Brixner DI
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Pharmacotherapy
JT  - Pharmacotherapy
JID - 8111305
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*adverse effects/therapeutic use
MH  - Case-Control Studies
MH  - Chemoprevention
MH  - Female
MH  - Heparin/*adverse effects/analogs & derivatives/therapeutic use
MH  - Hospitals, University
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Thrombocytopenia/chemically induced/*economics/epidemiology
MH  - Thromboembolism/*prevention & control
MH  - Utah/epidemiology
MH  - Venous Thrombosis/*prevention & control
EDAT- 2006/09/27 09:00
MHDA- 2007/02/23 09:00
CRDT- 2006/09/27 09:00
PHST- 2006/09/27 09:00 [pubmed]
PHST- 2007/02/23 09:00 [medline]
PHST- 2006/09/27 09:00 [entrez]
AID - 10.1592/phco.26.10.1438 [doi]
PST - ppublish
SO  - Pharmacotherapy. 2006 Oct;26(10):1438-45. doi: 10.1592/phco.26.10.1438.