Key result
Simple HIT scoring identifies positive lab assays in ~43% of possible-risk cases.
Observational (n=100)
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This study was performed to develop a simple scoring system to aid in the early clinical management of patients suspected of heparin-induced thrombocytopenia (HIT) with regard to decisions for continued heparin therapy. The system was designed to arrive at low (0) or possible (1) probability scores without knowledge of laboratory test results (except platelet counts) to avoid delays. As the safest clinical approach is to discontinue heparin, intermediate and high scores were combined. Critically ill VA hospital patients (n = 100) with a ≥30% fall in platelet count were assessed by platelet aggregation (PA), (14)C-serotonin release assay ((14)C-SRA), and GTI ELISA. In this population, 53% were scored 1 and of these 43% were positive by laboratory test. Emphasizing the decision to discontinue heparin, the clinical signs of HIT were paramount for the immediate determination of a diagnosis of HIT without dependence on a positive laboratory test.
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Messmore et al. (2010) conducted an observational in Suspected heparin-induced thrombocytopenia (HIT) (n=100). Simple clinical probability scoring system for HIT (score 1 = possible probability) vs. Laboratory testing (platelet aggregation, 14C-serotonin release assay, and GTI ELISA) / low probability score (0) was evaluated on Positive laboratory test for heparin-induced thrombocytopenia among patients with a possible probability score (1). The simple clinical HIT scoring system classified 53% of patients with a ≥30% platelet drop as possible HIT (score 1), of whom 43% tested positive by laboratory assays.
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