PMID- 19132240
OWN - NLM
STAT- MEDLINE
DCOM- 20090212
LR  - 20090109
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 100
IP  - 6
DP  - 2008 Dec
TI  - Heparin-induced thrombocytopenia (HIT): clinical and economic outcomes.
PG  - 1130-5
AB  - Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug 
      reaction that occurs following exposure to unfractionated heparin (UFH) or 
      low-molecular-weight heparin (LMWH). HIT with thrombosis (HITT) can cause 
      devastating venous thromboembolism or arterial clots, prolonged hospitalization, 
      and increased costs. To explore the economic and clinical implications of HIT and 
      HITT, we initiated a single-center patient registry. In this report, we describe 
      patient characteristics, comorbidities, management strategies, clinical outcomes, 
      and costs. We enrolled 349 hospitalized patients with an enzyme 
      immunoassay-confirmed diagnosis of HIT over a 40-month period. Patients were 
      assessed for the primary outcome of 30-day mortality, as well as baseline 
      characteristics, development of thrombosis, and the economic impact of HIT. The 
      primary outcome measure was 30-day mortality and occurred in 58 (16.6%) patients, 
      40 (15.3%) in the HIT group versus 18 (20.7%) in the HITT group (p = 0.25). The 
      frequency of HIT was greater in patients exposed to UFH than in patients exposed 
      to LMWH (0.8% vs. 0.2%, respectively, p < 0.001). Both HIT and HITT patients who 
      were exposed to UFH had higher hospital costs than those exposed to LMWH 
      ($113,100 vs. $56,352, respectively, p < 0.001). HIT remains an important 
      clinical problem with a high mortality rate and significant cost, regardless of 
      development of thrombosis. Prospective controlled trials need to be conducted to 
      determine the optimal strategy to reduce the frequency of HIT.
FAU - Baroletti, Steven
AU  - Baroletti S
AD  - Department of Pharmacy, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, MA 02115, USA. sbaroletti@partners.org
FAU - Piovella, Chiara
AU  - Piovella C
FAU - Fanikos, John
AU  - Fanikos J
FAU - Labreche, Matthew
AU  - Labreche M
FAU - Lin, Jay
AU  - Lin J
FAU - Goldhaber, Samuel Z
AU  - Goldhaber SZ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*adverse effects
MH  - Boston
MH  - Cost-Benefit Analysis
MH  - Female
MH  - Heparin/*adverse effects
MH  - Heparin, Low-Molecular-Weight/*adverse effects
MH  - *Hospital Costs
MH  - Humans
MH  - Length of Stay/economics
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Thrombocytopenia/chemically induced/*economics/mortality/*therapy
MH  - Thrombosis/chemically induced/*economics/mortality/*therapy
MH  - Time Factors
EDAT- 2009/01/10 09:00
MHDA- 2009/02/13 09:00
CRDT- 2009/01/10 09:00
PHST- 2009/01/10 09:00 [entrez]
PHST- 2009/01/10 09:00 [pubmed]
PHST- 2009/02/13 09:00 [medline]
AID - 08121130 [pii]
PST - ppublish
SO  - Thromb Haemost. 2008 Dec;100(6):1130-5.