Routine monitoring for heparin-induced thrombocytopenia following lower limb arthroplasty: Is it necessary? A prospective study in a UK district general hospital

Haughton, Benjamin A.; Haughton, Joanna; Norman, John George; Navid, Ahmad; Allport, Kathy; Andrews, Mark; Mannan, Ken; Livesey, J. R.

doi:10.1016/j.otsr.2018.12.012

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Thus, routine laboratory monitoring was not recommended for HIT after TJA. 10,25,27 However, according to our study, the cases of inpatient mortalities in post-THA patients were 13.75 times higher (2.2% vs. 0.16%) and 8.3 times higher than in post-TKA patients (0.58% vs. 0.07%), respectively. It is critical to identify the HIT risk factors and keep in mind that HIT may take place during LMWH exposure.…”

Section: Discussionmentioning

confidence: 49%

Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia after Total Joint Arthroplasty: An Analysis of the National Inpatient Sample Database

Chen

Wang

Shi

et al. 2020

Preprint

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Abstract Background Heparin-induced thrombocytopenia (HIT) is a severe immune-mediated complication of heparin exposure, leading to negative consequences after total hip (THA) and knee arthroplasty (TKA). However, the incidence and risk factors of HIT remain to be elucidated. This study aimed to identify the incidence, outcomes, and risk factors of HIT after THA and TKA. Methods A retrospective study was conducted using the National Inpatient Sample (NIS) database from 2005 to 2014. The incidence and outcomes of HIT after THA or TKA were documented. Logistic regression analysis was performed to identify the postoperative HIT risk factors. Results A total of 593,045 patients who underwent THA and 1,228,707 patients who underwent TKA were identified. The cumulative incidences were 0.02% and 0.01%, respectively. The HIT group presented significantly higher Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) scores, longer hospital stays (LOS), and higher medical costs. HIT led to a significantly higher mortality rate after THA (2.17% vs. 0.16%, p =0.0091). Although not statistically significant, the HIT mortality rate after TKA was also increased (0.58% vs. 0.07%; p =0.1178). In THA, the risk factors of HIT were racial minority, AIDS, pulmonary circulation disorders (PCD), psychoses, and hypertension; the protective factors were large-scale and teaching hospitals. In TKA, the HIT risk factors were racial minority, PCD, and weight loss. Teaching hospitals served as protective factors. Conclusions The incidence of HIT after THA and TKA is relatively low; however, HIT significantly increases inpatient mortality, LOS, and medical cost. Therefore, HIT warrants considerable attention and further investigation.

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Section: Discussionmentioning

confidence: 49%

Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia after Total Joint Arthroplasty: An Analysis of the National Inpatient Sample Database

Chen

Wang

Shi

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Thus, routine laboratory monitoring was not recommended for HIT after TJA. 7,19,21 However, according to our study, the cases of inpatient mortalities in post-THA patients were 13.75 times higher (2.2% vs 0.16%) and 8.3 times higher than in post-TKA patients (0.58% vs 0.07%), respectively. It is critical to identify the HIT risk factors and keep in mind that HIT may take place during LMWH exposure.…”

Section: Discussionmentioning

confidence: 49%

Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia After Total Joint Arthroplasty: A National Inpatient Sample Database Study

Chen

Wang

Shi

et al. 2021

Clin Appl Thromb Hemost

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Backgrounds: Heparin-induced thrombocytopenia (HIT) is a severe immune-mediated complication of heparin exposure, leading to negative consequences after total hip (THA) and knee arthroplasty (TKA). Materials and Methods: A retrospective study was conducted using the National Inpatient Sample (NIS) database from 2005 to 2014. The incidence and outcomes of HIT after THA or TKA were documented. Logistic regression analysis was performed to identify the postoperative HIT risk factors. Results: A total of 59 3045 patients who underwent THA and 1228 707 patients who underwent TKA were identified. The cumulative incidences were 0.02% and 0.01%, respectively. The HIT group presented significantly higher Charlson Comorbidity Index and Elixhauser Comorbidity Index scores, longer hospital stays (LOS), and higher medical costs. HIT led to a significantly higher mortality rate after THA (2.17% vs 0.16%, P = .0091). In THA, the HIT risk factors were racial minority, AIDS, pulmonary circulation disorders (PCD), psychoses, and hypertension. In TKA, the HIT risk factors were racial minority, PCD, and weight loss. Conclusion: The incidence of HIT after THA and TKA is relatively low; however, HIT significantly increases inpatient mortality, LOS, and medical cost.

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Factors predisposing to thrombosis after major joint arthroplasty

Dailiana

Stefanou

Varitimids

et al. 2020

WJO

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Routine monitoring for heparin-induced thrombocytopenia following lower limb arthroplasty: Is it necessary? A prospective study in a UK district general hospital

Cited by 3 publications

References 24 publications

Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia after Total Joint Arthroplasty: An Analysis of the National Inpatient Sample Database

Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia after Total Joint Arthroplasty: An Analysis of the National Inpatient Sample Database

Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia After Total Joint Arthroplasty: A National Inpatient Sample Database Study

Factors predisposing to thrombosis after major joint arthroplasty

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