Prevalence of Heparin-Induced Thrombocytopenia Type II among Cardiac Surgery Patients

Abdulrazaq Al-Jazairi, Reem Bahmaid, Nathem Akhras, Edward Devol, Elias Saad and Tarek Owaidah

Department of Pharmacy Services Administration, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Department ofPharmacy Services Administration, King Fahad Medical City, Riyadh, Saudi Arabia
Department of Pharmacy Services Administration, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Department ofEpidemiology &Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Department ofIntensivist Consultant, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Department ofHematology Consultant, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

^*Correspondance to: Reem Bahmaid 

 PDF  Full Text DOI: 10.25107/2474-1647.1538

Abstract

Objective: To assess the prevalence of heparin - induced thrombocytopenia type II (HIT) among suspected patients who received heparin in cardiac surgery intensive care unit at a single tertiary care hospital.Method: This is a retrospective cohort study conducted to calculate the prevalence of HIT type II among all patients who underwent cardiac surgery and tested for HIT over one decade, from 1st of January 2004 to 31st of December 2014. Patients who were suspected to have HIT were stratified according to the results of HIT assay result, using Diamed PaGIA and\or ELISA screening test, into two groups; HIT positive group and HIT negative group.Result: During the study period, 5,104 patients had cardiac surgery, 264 patients were suspected clinically to have HIT with a prevalence of 5.17% (95% CI, 4.59% to 5.81%). Out of these patients only 35 patients had positive test result, with a prevalence of 13.25% (95% CI, 9.11% to 17.28%). This makes the prevalence among the whole population to be 0.68% (95% CI, 0.45% to 0.91%). In the 264 cases of suspected HIT, the retrospectively calculated 4T’s probability score were high among 30 patients (11.4%), intermediate in 197 (74.6%) and low in 37 patients (14%). Among HIT negative patients there was a significant difference between risk of developing thrombocytopenia and selected pre-defined confounding variables; particularly sepsis and the use of cardiac devices (P value <0.001).Conclusion: The prevalence of true HIT type II among cardiac patients is rare, although it's not uncommon among clinically suspected cases.

Keywords

Heparin-induced thrombocytopenia; Low molecular weight heparin; CSICU

Cite the article

Abdulrazaq S, Reem Bahmaid, Nathem S, Edward B, Elias J Saad, Tarek M Owaidah. Prevalence of Heparin-Induced Thrombocytopenia Type II among Cardiac Surgery Patients. Clin Surg. 2017; 2: 1538.