2014
DOI: 10.1053/j.jvca.2013.07.021
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Incidence and Outcomes of Heparin-Induced Thrombocytopenia in Patients Undergoing Cardiac Surgery in North America: An Analysis of the Nationwide Inpatient Sample

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Cited by 42 publications
(43 citation statements)
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“…Of the 3 types of surgeries we evaluated, cardiac surgery had the highest HIT rate (0.5%), consistent with other studies. 4 The higher HIT/HITT rates found for larger urban hospitals in our study might be attributable to increased awareness and testing, availability of hematology consultation, and higher risk of heparin use in this setting, where patients are sicker and cases and procedures more complicated.…”
Section: Discussionmentioning
confidence: 60%
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“…Of the 3 types of surgeries we evaluated, cardiac surgery had the highest HIT rate (0.5%), consistent with other studies. 4 The higher HIT/HITT rates found for larger urban hospitals in our study might be attributable to increased awareness and testing, availability of hematology consultation, and higher risk of heparin use in this setting, where patients are sicker and cases and procedures more complicated.…”
Section: Discussionmentioning
confidence: 60%
“…3 Older patients and female patients, especially those who undergo surgery, are thought to be at higher risk. 4 Progression from HIT to HITT can occur in up to 50% of surgical patients, 5 and HITT can significantly increase mortality. 4 In the United States, LMWH use has increased 5-fold since 2000-an increase attributed to the 2010 release of generic enoxaparin.…”
mentioning
confidence: 99%
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“…Nearly 20% (by activation assay) and 50% (by antigen assay) of patients undergoing cardiac surgery have antibodies to heparin/PF-4 complexes, yet the incidence of HITTS-related thrombosis is only 0.3%–1% 10 11. However, postoperative cardiac surgery mortality associated with HITTS may exceed 20%,12 with a >50% increased mortality risk 10. Therefore, early recognition is critical.…”
Section: Discussionmentioning
confidence: 99%
“…To date, the only well-established anticoagulation protocol involves the use of heparin, which owing to its predictability, rapid action and reversibility with protamine, becomes an integral part of cardiac operations performed with and without extracorporeal circulation. However, re-exposure of HIT or HIT/T patients to heparin should be avoided as the possibility of severe thromboembolic events and even risk of death is increased postoperatively [5][6][7][8][9] and on rare occasions during surgery (Melissari et al, unpublished data). In these patients, alternative anticoagulation must be used.…”
Section: Introductionmentioning
confidence: 99%