For citation purposes: Udeh CI, Douglas A, Udeh BL, Hata JS. Heparin-induced thrombocytopenia: a clinical and economic review. OA Anaesthetics 2013 Mar 01;1(1):3.

Review

 
Medicine

Heparin-induced thrombocytopenia: a clinical and economic review

CI Udeh,, A Douglas, BL Udeh, JS Hata
 

Authors affiliations

(1) Center for Critical Care, Department of Cardiothoracic Anesthesia, Cleveland Clinic, Cleveland, Ohio

(2) Department of Cardiothoracic Anesthesia, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio

(3) Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio

(4) Center for Critical Care, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio

* Corresponding author E-mail: udehc@ccf.org

Abstract

Introduction

Heparin-induced thrombocytopenia is a serious immune-mediated, drug adverse effect. Research over the last 20 years has vastly expanded knowledge, awareness and management of this condition. This review includes findings mostly from primary source clinical and economic literature from this time period to synthesise a concise summary. We have highlighted key points regarding the pathophysiology, epidemiology and presentation, diagnosis and management, as well as the economic impact of heparin-induced thrombocytopenia. It is established that heparin-induced thrombocytopenia is relatively uncommon overall, despite the widespread use of heparin. However, delayed recognition leads to significantly increased morbidity, mortality and disability. Treatment requires prolonged courses of expensive alternative anticoagulants. All of these impose substantial costs to patients, hospitals and society. The aim of this review was to assess the clinical and economic factors influencing heparin-induced thrombocytopenia.

Conclusion

Heparin-induced thrombocytopenia remains a significant clinical problem and is associated with morbidity, mortality and disability. Using heparin products can reduce (but not eliminate) the incidence of heparin-induced thrombocytopenia. Properly administered treatment with factor Xa inhibitors or direct thrombin inhibitors can significantly decrease the direst complications of this condition and mitigate its economic impact.

Licensee OA Publishing London 2013. Creative Commons Attribution License (CC-BY)
Keywords