医学
肝素诱导血小板减少症
入射(几何)
蛛网膜下腔出血
内科学
回顾性队列研究
并发症
队列
肝素
外科
光学
物理
作者
Boyi Li,Tolga Sursal,Erick Martinez,Zafar Karimov,Eric Feldstein,Alan Stein,Jared Cooper,Rasheed Hosein‐Woodley,Aiden Liu,Matthew K. McIntyre,Christian A. Bowers,Simon Hanft,Zeeshan Hafeez,Jared Pisapia,Carrie R. Muh,Rachana Tyagi,Stephan A. Mayer,Chirag D. Gandhi,Fawaz Al‐Mufti
标识
DOI:10.1177/15910199221091643
摘要
Background Heparin induced thrombocytopenia Type II (HIT-II) is a dangerous thromboembolic complication of heparin therapy. The current literature on incidence and outcomes of HIT-II in aneurysmal subarachnoid hemorrhage (aSAH) patients remains sparse. Objective We report our institution's incidence and outcomes of HIT-II in aSAH patients. Methods We performed a retrospective cohort study at an academic medical center between June 2014 and July 2018. All patients had aSAH confirmed by digital subtraction angiography. Diagnosis of HIT-II was determined by positive results on both heparin PF4-platelet antibody ELISA (anti-PF4) and serotonin release assay (SRA). Results 204 patients met inclusion criteria. Seven patients (7/204, 3.5%) underwent laboratory testing, three of whom met clinical criteria. HIT-II incidence was confirmed in two of these seven patients (2/204, 0.98%), who had high BMI and T4 scores. Conclusion Our institution's report of HIT-II incidence in aSAH patients is lower than previously reported in this population and more closely parallels HIT-II incidence in the general and surgical ICU setting. Widely-accepted American College of Chest Physicians (ACCP) clinical diagnostic criteria in conjunction with anti-PF4 and SRA testing is the gold standard of clinical diagnosis of HIT-II in aSAH patients.
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