use of heparin and the related incidence of heparininduced thrombocytopenia in an education and research hospital in turkey

Abstract

Objective: We analyzed the incidence of heparin-induced thrombocytopenia in a group of patients who received heparin (LMWH, UFH) in an education and research hospital using the 4T test score as a diagnostic tool. Patients and Methods: A retrospective descriptive study analyzing patients using heparin preparations within the years 2015 and 2016. The risk for heparin-induced thrombocytopenia was calculated using the 4T test score system and also the monitoring of platelet counts of each patient. Results: Of 19.257 patients who used either UFH or LMWH and were admitted to the hospital within 2015 and 2016, 308 patients were suspected to have thrombocytopenia based on their individual platelet counts by excluding only patients with thrombocytopenia. 100 patients were determined to probably have heparin-induced thrombocytopenia and were further evaluated using the 4t test score. Overall risk was calculated to be 0.5%. Incidence was calculated to be 0.15% (29 out of 19257). For patients with high-risk scores, the incidence was 0.01% (2 out of 19257). Patients who had a high 4T test score were using ranitidine. In 29 patients who had intermediate and high-risk probability for HIT, mean starting day of HIT was 6.24±3.68 days; mean withdrawal day of heparin was 9,55±5,86 days and mean delay of heparin withdrawal was 3.31±3.39 days. Conclusion: Although the use of LMWH is being favored in the hospital when compared to UFH, health care practitioners should still remain vigilant about the occurrence of HIT as a complication of heparin therapy in hospitalized patients most especially within the first few weeks following heparin administration.