2017
DOI: 10.1177/0885066617722707
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Prevalence and Overtesting of True Heparin-Induced Thrombocytopenia in a 591-Bed Tertiary Care, Teaching Hospital

Abstract: Heparin-induced thrombocytopenia type II (HIT) is a rare but potentially fatal antibody-mediated reaction to all forms of heparin (unfractionated heparin, low-molecular weight heparin, heparin flushes, and heparin-coated catheters), which can lead to HIT with thrombosis. Two tests commonly used to screen for HIT include the enzyme-linked immunosorbent assay (ELISA) and serotonin release assay (SRA). This is a retrospective chart review study conducted from January 1, 2013, through December 31, 2014, to estimat… Show more

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Cited by 7 publications
(10 citation statements)
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“…4 In that study, the cost of testing for patients with a low probability 4T score was US$40,591. 4 In our study, the largest proportion of tests was in low-probability patients and incurred a testing cost of US$23,617. These results reflect a wider problem with overtreatment and low-value testing, as a recent literature review estimated that these issues incur a "waste" cost of between $75.7 and $101.2 billion in the United States annually.…”
Section: Discussionmentioning
confidence: 92%
See 2 more Smart Citations
“…4 In that study, the cost of testing for patients with a low probability 4T score was US$40,591. 4 In our study, the largest proportion of tests was in low-probability patients and incurred a testing cost of US$23,617. These results reflect a wider problem with overtreatment and low-value testing, as a recent literature review estimated that these issues incur a "waste" cost of between $75.7 and $101.2 billion in the United States annually.…”
Section: Discussionmentioning
confidence: 92%
“…In the diagnosis of HIT, the HIT Ab is generally more widely available and faster than the more specific and sensitive SRA. 4 For this reason, the HIT Ab is used to screen for HIT and SRA is used to confirm a positive HIT Ab. The HIT Ab can return false positives in patients with other antibody-mediated diseases, such as SLE, however, and therefore should be evaluated in conjunction with a patient's clinical picture.…”
Section: Discussionmentioning
confidence: 99%
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“…This can be attributed to the higher cost, turnaround time, and resource intensiveness associated with SRAs, limiting their use in most settings around the globe. 86 While the sensitivity and specificity of SRAs and ELISA have not been compared in TTS patients, evidence extrapolated from HIT suggests that SRAs, however, could potentially be helpful in patients with negative or equivocal ELISA findings but strong suspicion of TTS, owing to their greater specificity in HIT. 87 However, this necessitates further investigations, considering that patients with negative ELISA results were excluded from this review.…”
Section: Discussionmentioning
confidence: 99%
“…HIT is classified as type I (non‐antibody‐mediated reaction to heparin) or type II (antibody‐mediated reaction against heparin‐platelet factor 4 complex). HIT type II is more severe and leads to platelet activation and an increased risk of thrombosis 16 . HIT is commonly associated with both venous and arterial thrombosis, leading to skin necrosis, limb gangrene, and organ ischemia 17 .…”
Section: Specific Considerations Regarding Anticoagulation Strategiesmentioning
confidence: 99%