Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.
Division of Hematology and Oncology, Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, MI, USA.
Br J Haematol. 2020 May;189(3):543-550. doi: 10.1111/bjh.16400. Epub 2020 Jan 28.
Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse reaction to heparin products characterized by thrombocytopenia with or without thrombosis. This study aimed to determine the incidence, morbidity, mortality and economic burden of HIT in solid-malignancy-related hospitalizations. We analyzed the National Inpatient Sample Database (NIS), the largest public database of hospital admissions in the United States, from January 2012 to September 2015. The primary outcome of the study was the incidence of HIT. Secondary outcomes included incidence of venous thrombosis (acute deep venous thrombosis and pulmonary embolism), arterial thrombosis (thrombotic stroke, myocardial infarctions and other arterial thromboembolism), mortality associated with HIT, length of stay, total hospital charges and disposition. During the study period, 7 437 049 hospitalizations had an associated diagnosis of solid malignancy. Approximately 0·08% (n = 6225) hospitalizations had a secondary diagnosis of HIT in this population. The standardized incidence of total thrombotic events was higher in the solid malignancy with HIT compared to the solid malignancy without HIT group (24·7% vs. 6·8%, P < 0·001). The standardized mortality rate was 4·8% in solid malignancy with HIT compared to 3·4% in the without HIT group (OR, 1·53; 95% CI, 1·25-1·89; P < 0·001). HIT in solid malignancy is a rare condition but associated with increased morbidity and mortality.
肝素诱导的血小板减少症（HIT）是一种免疫介导的肝素产品不良反应，其特征为伴有或不伴有血栓形成的血小板减少症。本研究旨在确定实体恶性肿瘤相关住院患者中 HIT 的发生率、发病率、死亡率和经济负担。我们分析了美国最大的公共住院患者数据库——国家住院患者样本数据库（NIS），时间范围为 2012 年 1 月至 2015 年 9 月。本研究的主要结局是 HIT 的发生率。次要结局包括静脉血栓形成（急性深静脉血栓形成和肺栓塞）、动脉血栓形成（血栓性中风、心肌梗死和其他动脉血栓栓塞）、与 HIT 相关的死亡率、住院时间、总住院费用和出院情况。在研究期间，7437049 例住院患者存在实体恶性肿瘤的相关诊断。在该人群中，约有 0.08%（n=6225）的住院患者有 HIT 的二级诊断。与无 HIT 组相比，HIT 合并实体恶性肿瘤的总血栓事件发生率更高（24.7%比 6.8%，P<0.001）。HIT 合并实体恶性肿瘤的标准化死亡率为 4.8%，而无 HIT 组为 3.4%（OR，1.53；95%CI，1.25-1.89；P<0.001）。HIT 合并实体恶性肿瘤是一种罕见疾病，但与发病率和死亡率增加有关。
