Heparin-Induced Thrombocytopenia and In-Hospital Outcomes in Patients Receiving Ventricular Assist Devices

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Publication Date

November 2017

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Background: Unfractionated heparin (UFH) is commonly used as an anticoagulation strategy in patients receiving ventricular assist devices (VADs) to reduce pump thrombosis. Heparininduced thrombocytopenia (HIT) is a potential serious complication that can occur with UFH use. The aim of this study was to investigate the association between the diagnosis of HIT and inhospital outcomes in patients receiving VADs. Methods: We performed a retrospective analysis of the United States National Inpatient database years 2009 to 2012 to identify a weighted sample of patients ≥18 years undergoing VAD implantation. In this cohort, hospitalizations with a primary or secondary discharge diagnosis of HIT were identified. Appropriate ICD9 codes were used to identify diagnoses. Trends in the diagnosis of HIT and its association with length of stay (LOS), total hospital charges, and inpatientmortality before and after adjustment for relevant baseline demographics and comorbidities were analyzed. Results: In patients undergoing VAD implantation (n=10,298; mean age 56 years, 77% male), HIT was diagnosed in 2.5% (n=255, mean age 51 years, 71% male). Proportion of cases with HIT increased from 1.8% in 2009 to 3.1% in 2012 (P =0.004). In univariate analysis, HIT was associated with increased allcause inpatient mortality (26.3% in HIT group vs 14% without HIT; P