Heparin-induced thrombocytopenia epidemiology and demographics
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Heparin-induced thrombocytopenia |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2] Shyam Patel [3]
Overview
Heparin-induced thrombocytopenia (HIT) occurs in persons who are exposed to heparin or heparin-related products. The majority of medically or surgically hospitalized patients are exposure to heparin in some form, so the incidence of HIT can be quite high in these persons. The incidence of HIT is higher with certain type of heparin (such as bovine instead of porcine heparin) and in certain types of patients (such as surgical patients instead of obstetric or pediatric patients). There are no geographic or racial disparities in HIT, but it is known that HIT occurs more commonly in females compared to males.
Epidemiology and demographics
Prevalence
- Worldwide, the prevalence of HIT (in persons exposed to heparin) ranges from a low of 200 per 100,000 persons to a high of 5,000 per 100,000 persons.[1][2]
- In pediatric populations, the prevalence of HIT (in persons exposed to heparin) ranges from a low of 1,500 per 100,000 persons to a high of 3,700 per 100,000 persons with an average prevalence of 2,600 per 100,000 persons.[2] The prevalence is 1-3% in children exposed to unfractionated heparin and undergoing cardiac surgery.[3]
- In neonatal populations, the prevalence of HIT (in persons exposed to heparin) is as low as 330 per 100,000 persons.[2]
Incidence
The statistics for HIT are best reported as prevalence rather than incidence, given the nature of the how the disease develops. The statistics are shown the Prevalence section.
Case Fatality Rate
- The case fatality rate of HIT is 20-30% for patients who develop thrombosis.[4]
- For patients who have HIT but do not develop thrombosis, the case fatality rate is unknown but is lower than 20-30%.[4]
Age
- The adult population is more prone to development of HIT than the pediatric population. Please see the Prevalence section above for the prevalence of HIT in pediatric and neonatal populations.
Gender
- Females are more commonly affected with HIT than males. The female to male ratio is approximately 2.4 to 1.[5] This is thought to be related to higher predilection for autoimmune tendencies in females compared to males.
Race
- HIT is more prevalent in the African American race than the Caucasian race.[5]
Developed Countries
HIT has a major impact on society in developed countries. Development of HIT can lead to high morbidity and mortality in hospitals and can increase health care costs. For example, the development of thrombotic complications can lead to the need for prolonged anticoagulation and monitoring, which places a burden on the healthcare system.
Developing Countries
There is minimal data on HIT in developing countries. There is no variation in prevalence of HIT in developing countries.
Reference
- ↑ Arepally GM, Ortel TL (2010). "Heparin-induced thrombocytopenia". Annu Rev Med. 61: 77–90. doi:10.1146/annurev.med.042808.171814. PMC 4153429. PMID 20059332.
- ↑ 2.0 2.1 2.2 Obeng EA, Harney KM, Moniz T, Arnold A, Neufeld EJ, Trenor CC (2015). "Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system". J Pediatr. 166 (1): 144–50. doi:10.1016/j.jpeds.2014.09.017. PMC 4274245. PMID 25444534.
- ↑ Vakil NH, Kanaan AO, Donovan JL (2012). "Heparin-induced thrombocytopenia in the pediatric population: a review of current literature". J Pediatr Pharmacol Ther. 17 (1): 12–30. doi:10.5863/1551-6776-17.1.12. PMC 3428184. PMID 23118656.
- ↑ 4.0 4.1 Franchini M (2005). "Heparin-induced thrombocytopenia: an update". Thromb J. 3: 14. doi:10.1186/1477-9560-3-14. PMC 1262784. PMID 16202170.
- ↑ 5.0 5.1 Lee GM, Arepally GM (2013). "Diagnosis and management of heparin-induced thrombocytopenia". Hematol Oncol Clin North Am. 27 (3): 541–63. doi:10.1016/j.hoc.2013.02.001. PMC 3668315. PMID 23714311.