Chaudhry Rabail, Wegner Robert, Zaki John F, Pednekar Greesha, Tse Alex, Kukreja Naveen, Grewal Navneet, Williams George W
Department of Anesthesiology, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX.
Department of Anesthesiology, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX.
J Cardiothorac Vasc Anesth. 2017 Oct;31(5):1751-1757. doi: 10.1053/j.jvca.2017.05.024. Epub 2017 May 17.
The National Inpatient Sample (NIS) from years 2010 through 2012 was utilized to determine the incidence, predictive risk factors, and outcomes of heparin-induced thrombocytopenia (HIT) in patients undergoing vascular surgery.
Retrospective population-based study.
Data from the National Inpatient Sample (NIS) (2011 through 2013) using specific International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure codes corresponding with vascular surgery.
425,379 hospital admissions in patients which underwent vascular surgery. Among these, 1,290 (0.31%) were diagnosed with HIT, and 17,765 (4.18%) were diagnosed with secondary thrombocytopenia.
The incidence of HIT is 0.3% in the vascular surgery population. The highest incidence is observed in thoraco-subclavian and vein reconstruction procedures. This study indicated that liver disease, endocarditis, chronic renal failure, congestive heart failure, atrial fibrillation, obesity, and female sex are associated with a higher incidence of HIT in this population. In vascular surgery patients, HIT can increase mortality by 3-fold and lead to severe complications such as acute renal failure, venous embolism, pulmonary embolism, and respiratory failure.
The incidence of HIT in the vascular surgery population is similar to previously reported incidence in cardiac surgery patients. In the vascular surgery population, mortality increases 3-fold in patients with HIT versus those without any thrombocytopenia. Understanding the associated risk factors and complications will allow clinicians to make informed decisions and anticipate HIT and associated complications in certain high-risk populations.
利用2010年至2012年的全国住院患者样本（NIS）来确定血管手术患者中肝素诱导的血小板减少症（HIT）的发病率、预测风险因素及结局。
基于人群的回顾性研究。
使用与血管手术相应的特定国际疾病分类第九版临床修订本（ICD-9-CM）程序编码，从全国住院患者样本（NIS）（2011年至2013年）中获取数据。
425,379例接受血管手术的住院患者。其中，1290例（0.31%）被诊断为HIT，17,765例（4.18%）被诊断为继发性血小板减少症。
血管手术人群中HIT的发病率为0.3%。在胸-锁骨下和静脉重建手术中观察到最高发病率。本研究表明，肝病、心内膜炎、慢性肾衰竭、充血性心力衰竭、心房颤动、肥胖和女性与该人群中HIT的较高发病率相关。在血管手术患者中，HIT可使死亡率增加3倍，并导致严重并发症，如急性肾衰竭、静脉栓塞、肺栓塞和呼吸衰竭。
血管手术人群中HIT的发病率与先前报道的心脏手术患者的发病率相似。在血管手术人群中，与无任何血小板减少症的患者相比，HIT患者的死亡率增加3倍。了解相关风险因素和并发症将使临床医生能够做出明智的决策，并预测某些高危人群中的HIT及相关并发症。
