Incidence of heparin induced thrombocytopenia in hospitalized patients treated with unfractionated heparin in the Azady general hospital

Abstract

Heparin induced thrombocytopenia (HIT) is a drug induced immune-mediated syndrome characterized by thrombocytopenia and thrombotic events that may be life-or limb threatening. HIT occurs in up to 5% of patients receiving unfractionated heparin (UFH), and less than 1% of patients receiving LMWH. The Aims of the study is to determine the Incidence of heparin induced thrombocytopenia in hospitalized Patients treated with unfractionated heparin in the Azady general hospital. This study was carried out on 40 patients treated with UFH addimited to the Azady general hospital. Each patient underwent a full clinical evaluation including; disease history, and a physical exam. Blood samples were taken for laboratory tests at base line and every day up to patients discharge, including:- EDTA blood for platelet count and blood film, and Serum was obtained from clotted samples for renal and liver function tests. There was mild reduction in platelet count (<30% of base line value) in 27.5% of the patients included in this study. A small proportion 7.5% of the patients showed significant reduction in platelet count (³30% of base line value) and only one of them (2.5%) progressed to more severe reduction in platelet count (³50% of base line value) at the 6th day which was labeled as HIT. Stoppage of heparin use in those with significant reduction in platelet count lead to elevation in platelet count within hours up to three days after stopping heparin. All the patients who showed significant reduction in platelet count including the patient with HIT were on IV heparin infusion and none of them were on subcutaneous injection, which is statistically not significant. The cumulative incidence of HIT over all samples was 7% in the first 6 days and even whole follow up period