NYMC Faculty Publications
Outcomes of Heparin-Induced Thrombocytopenia Type II in Aneurysmal Subarachnoid Hemorrhage Patients: A US Nationwide Analysis
Author Type(s)
Student, Resident/Fellow, Faculty
DOI
10.1136/jnis-2023-021438
Journal Title
Journal of Neurointerventional Surgery
Document Type
Article
Publication Date
4-17-2024
Department
Dental Medicine
Second Department
Neurosurgery
Third Department
Neurology
Keywords
aneurysm, complication, hemorrhage, subarachnoid
Disciplines
Medicine and Health Sciences
Abstract
Background Despite the widespread use of heparin during and following endovascular procedures in the management of aneurysmal subarachnoid hemorrhage (SAH) patients, limited research has explored the incidence and impact of heparin-induced thrombocytopenia (HIT) on SAH. Methods Descriptive statistics, multivariate regressions, and propensity score-matching were employed to compare clinical characteristics, comorbidities, interventions, complications, and outcomes of HIT in SAH patients identified within the US National Inpatient Sample database from 2010 to 2019. Results Among 76 387 SAH patients from 2010 to 2019, 166 (0.22%) developed HIT. HIT was identified as a significant predictor of prolonged length of stay (OR 6.799, 95% CI 3.985 to 11.6, P<0.01) and poor functional outcomes (OR 2.541, 95% CI 1.628 to 3.966, P<0.01) after adjusting for relevant factors. HIT incidence was higher in patients with elevated SAH severity scores (1.42 vs 1.06, P<0.01), younger patients (58.04 vs 61.39 years, P=0.01), overweight individuals (0.4% vs 0.2%, P<0.01), those on long-term anticoagulants (10.84% vs 5.72%, P<0.01), or with a cerebrospinal fluid drainage device (external ventricular drain, ventriculoperitoneal shunt; P<0.01). HIT patients showed increased rates of endovascular coiling, ventricular drain placement, shunt placement, deep vein thrombosis, urinary tract infection, acute kidney injury, pulmonary embolism, venous sinus thrombosis, pneumonia, and cerebral vasospasm (all P<0.01). Conclusion SAH patients with HIT exhibited various comorbidities and increased rates of complications, which may contribute to extended hospital stays. This nationwide study aids clinical suspicion and highlights HIT's impact on SAH patients.
Recommended Citation
Subah, G., Zeller, S., Damodara, N., Fortunato, M., Garrett, J., Syed, S., Uddin, A., Pak, I., Feldstein, E., Mayer, S., Gandhi, C., & Al-Mufti, F. (2024). Outcomes of Heparin-Induced Thrombocytopenia Type II in Aneurysmal Subarachnoid Hemorrhage Patients: A US Nationwide Analysis. Journal of Neurointerventional Surgery, 17 (4). https://doi.org/10.1136/jnis-2023-021438
