Key result
Postoperative heparin-induced thrombocytopenia was associated with an enhanced risk of renal failure, infectious and thromboembolic complications, and in-hospital mortality.
Why the study?
Heparin-induced thrombocytopenia (HIT) is a serious complication after cardiac surgery, and predictors for its postoperative occurrence and impact on outcome need identification.
What are the predictors and clinical consequences of heparin-induced thrombocytopenia after cardiac surgery?
Cohort (n=5,073)
What are the predictors and clinical consequences of heparin-induced thrombocytopenia after cardiac surgery?
Postoperative HIT after cardiac surgery is associated with significant morbidity and mortality, and can be predicted by specific pre- and intraoperative factors.
Answers are grounded in this paper and cite their sources.
Signals need for vigilant monitoring after cardiac surgery; leaves open whether predictor-targeted strategies reduce HIT complications.
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a serious complication after cardiac surgery. The aim of the present study was to identify pre- and intraoperative predictors for the postoperative occurrence of HIT. The study additionally focused on the impact of HIT on postoperative outcome. METHODS: Retrospective analysis was performed for 5073 patients who had required extracorporeal circulation during cardiac surgery. Patients were divided into 3 groups: 1) patients who had postoperative HIT (HIT+); 2) patients with postoperative thrombocytopenia but without HIT (HIT-); and 3) patients with normal platelet count (C). The groups were statistically compared with regard to pre-, intra- and postoperative parameters. RESULTS: Statistically significant predictors were renal insufficiency, intravenous application of heparin for more than 3 days, previous percutaneous coronary intervention within the last 4 weeks, urgency/emergency operation, combined surgery, prolonged extracorporeal circulation or cross-clamping time, and low cardiac output syndrome. Postoperative HIT was associated with an enhanced risk of renal failure, infectious and thromboembolic complications and in-hospital mortality. CONCLUSION: Postoperative HIT increases morbidity and mortality. The predictors presented in this study can be used to identify patients at risk of developing HIT.
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Assmann et al. (2010) conducted a cohort in Cardiac surgery requiring extracorporeal circulation (n=5,073). Heparin-induced thrombocytopenia (HIT) vs. Postoperative thrombocytopenia without HIT or normal platelet count was evaluated on Postoperative occurrence of HIT and postoperative outcome (renal failure, infectious and thromboembolic complications, and in-hospital mortality). Postoperative heparin-induced thrombocytopenia was associated with an enhanced risk of renal failure, infectious and thromboembolic complications, and in-hospital mortality.
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