Clinical characteristics and laboratory testing of patients with suspected HIT: a survey on current practice in 11 university hospitals in France.

Abstract

UNLABELLED:

We undertook a survey of French university hospital hematological laboratories to ascertain the clinical characteristics of patients with suspected HIT, the laboratory tests performed, and the therapeutic strategy adopted in current practice.

METHODS:

A standardized medical records database for patients with suspected HIT was sent to 19 laboratories. During two months, all consecutive patients for whom a biological test was performed were included.

RESULTS:

169 patients were included, 27 (16%) patients having a final diagnosis of HIT. At the time HIT was suspected, the heparin duration and the level of thrombocytopenia were similar in HIT- positive and HIT-negative groups. The use of unfractionated heparin, a therapeutic heparin dose regimen and the presence of thrombotic complications were significantly more frequent in HIT-positive patients. When the heparin dose regimen was taken into account, only thrombotic complications under a therapeutic dose regimen were significantly increased in HIT-positive patients. Eighty-six percent of patients presented at least one alternative diagnosis of thrombocytopenia without significant difference between the two groups. Laboratory tests were performed after a mean of 0.3days and mainly consisted of antigen assays. At the time HIT was suspected, heparin was stopped in 56 (33%) patients, being replaced mainly by danaparoid. Only three laboratories declared they usually received all the necessary clinical information to establish the likelihood of HIT.

CONCLUSION:

In current practice in France, the clinical probability of HIT is rarely established, leading to systematic requests for laboratory HIT tests.

• Authors: Audrey Bidet, Brigitte Tardy Poncet, Dominique Desprez, Emmanuel de Maistre, Emilie Presles, Thomas Lecompte, Cecile Lavenu-Bombled, Marie Genevieve Huisse, Martine Wolf, Pierre Morange, Evelyne Racadot, Christine Mouton, Lelia Grunebaum, Claire Pouplard, Bernard Tardy, GEHT-HIT study group
• Journal: Thrombosis research (Thromb Res) Vol. 125 Issue 6 Pg. e294-9 (Jun 2010) ISSN: 1879-2472 [Electronic] United States
• PMID: 20181380 (Publication Type: Journal Article)
• Copyright: Copyright 2010 Elsevier Ltd. All rights reserved.

Chemical References

• Dermatan Sulfate
• Heparin
• Chondroitin Sulfates
• Heparitin Sulfate
• danaparoid

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Chondroitin Sulfates (therapeutic use)
• Clinical Laboratory Techniques (statistics & numerical data)
• Data Collection
• Dermatan Sulfate (therapeutic use)
• Female
• France
• Heparin (adverse effects, therapeutic use)
• Heparitin Sulfate (therapeutic use)
• Hospitals, University
• Humans
• Male
• Medical Records
• Middle Aged
• Practice Patterns, Physicians' (statistics & numerical data)
• Thrombocytopenia (chemically induced, diagnosis, immunology)
• Thrombosis (complications, drug therapy)
• Young Adult