Heparin-induced thrombocytopenia epidemiology and demographics: Difference between revisions
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* | *HIT can occur in any age group. Age is not a risk factor for HIT. Please see the Prevalence section above for the prevalence of HIT in pediatric and neonatal populations. | ||
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Revision as of 22:09, 29 July 2017
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Heparin-induced thrombocytopenia |
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Differentiating Heparin-induced thrombocytopenia from other Diseases |
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Diagnosis |
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Treatment |
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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
- HIT can occur in any age group. Age is not a risk factor for HIT. Please see the Prevalence section above for the prevalence of HIT in pediatric and neonatal populations.
Gender
This section describe how prevalence of the disease varies by gender. When describing male to female ratios with decimal points, avoid reporting more than 1 number after the decimal point. For example, report a ratio as as 1.5 to 1 instead of 1.48294 to 1. Many numbers after the decimal point may suggest a false sense of accuracy. You can use either of the following template sentences:
- ______ (insert gender 1) are more commonly affected with ______ (insert disease name) than _____ (insert gender 2). The _____ (insert gender ratio e.g. male to female) ratio is approximately _____ (insert number > 1) to 1.
- The prevalence and incidence of (insert disease state here) does not vary by gender.
- Men and women are affected equally by (insert disease name here).
- (Insert disease state here) is more prevalent in men women.
- The prevalence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.
- The incidence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.
Race
This section describes how the disease differs based upon race. You can use the following template sentence for this section:
- The prevalence of _____ (insert disease) does not vary by race.
- (Insert disease state here) is more prevalent in the ____ (inser race) race and ____ (insert other race) races.
- There is no racial predilection for ____ (insert disease name)
- _____ (insert disease) usually affects individuals of the _____ (inser race) race. _____ (insert other race) individuals are less likely to develop ______ (disease name).
Developed Countries
- In this section you should describe the impact of the disease in developed countries.
- Incidence, prevalence, and geographical distribution or areas of interest can be mentioned, as well as the relevant impact the disease has on society.
Developing Countries
- In this section you should describe the impact of the disease in developing countries.
- Incidence, prevalence, and geographical distribution or areas of interest can be mentioned, as well as the relevant impact the disease has on society.
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.