PMID- 19682670
OWN - NLM
STAT- MEDLINE
DCOM- 20091015
LR  - 20090929
IS  - 1555-7162 (Electronic)
IS  - 0002-9343 (Linking)
VI  - 122
IP  - 10
DP  - 2009 Oct
TI  - Incidence of thrombocytopenia in hospitalized patients with venous 
      thromboembolism.
PG  - 919-30
LID - 10.1016/j.amjmed.2009.03.026 [doi]
AB  - PURPOSE: To determine the incidence of heparin-associated thrombocytopenia in 
      patients receiving prophylaxis or treatment for venous thromboembolism. METHODS: 
      We assessed the database of the National Hospital Discharge Survey from 1979 
      through 2005 and complemented this with a meta-analysis of published literature. 
      RESULT: Among 10,554,000 patients discharged from short-stay hospitals throughout 
      the US with venous thromboembolism during the 27 years of study, secondary 
      thrombocytopenia was coded in 38,000 patients (0.36%). From 1979 through 1992, 
      secondary thrombocytopenia was coded in only 0.15% of hospitalized patients with 
      venous thromboembolism. The frequency increased sharply to 0.54% from 1993 
      through 2005. Secondary thrombocytopenia was rarely diagnosed among 1,446,000 
      patients aged <40 years and among 77,000 women who had venous thromboembolism 
      with deliveries. Meta-analysis of published literature showed a higher incidence 
      among patients who received unfractionated heparin (UFH) for prophylaxis than 
      those who received low-molecular-weight heparin (LMWH) for prophylaxis. Treatment 
      resulted in smaller differences of the incidence between UFH and LMWH. 
      CONCLUSION: Heparin-associated thrombocytopenia is rare among patients aged <40 
      years and women following delivery. The risk of heparin-associated 
      thrombocytopenia is more duration-related than dose-related, and higher with UFH 
      when used for an extended duration. Our findings and those of the literature 
      suggest that although heparin-associated thrombocytopenia is uncommon, the 
      incidence can be minimized by use of LMWH, particularly if extended prophylaxis 
      or extended treatment is required.
FAU - Stein, Paul D
AU  - Stein PD
AD  - Research and Advanced Studies Program, Michigan State University, College of 
      Osteopathic Medicine, Detroit Medical Center Campus, Detroit, MI, USA. 
      steinp@trinity-health.org
FAU - Hull, Russell D
AU  - Hull RD
FAU - Matta, Fadi
AU  - Matta F
FAU - Yaekoub, Abdo Y
AU  - Yaekoub AY
FAU - Liang, Jane
AU  - Liang J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20090813
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Adult
MH  - Age Distribution
MH  - Anticoagulants/adverse effects/therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*adverse effects
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Pregnancy
MH  - Prognosis
MH  - Risk Assessment
MH  - Sex Distribution
MH  - Thrombocytopenia/*chemically induced/*epidemiology/physiopathology
MH  - United States/epidemiology
MH  - Venous Thromboembolism/diagnosis/*drug therapy/*epidemiology
RF  - 61
EDAT- 2009/08/18 09:00
MHDA- 2009/10/16 06:00
CRDT- 2009/08/18 09:00
PHST- 2008/12/04 00:00 [received]
PHST- 2009/03/16 00:00 [revised]
PHST- 2009/03/18 00:00 [accepted]
PHST- 2009/08/18 09:00 [entrez]
PHST- 2009/08/18 09:00 [pubmed]
PHST- 2009/10/16 06:00 [medline]
AID - S0002-9343(09)00437-9 [pii]
AID - 10.1016/j.amjmed.2009.03.026 [doi]
PST - ppublish
SO  - Am J Med. 2009 Oct;122(10):919-30. doi: 10.1016/j.amjmed.2009.03.026. Epub 2009 
      Aug 13.