Simple Scoring System for Early Management of Heparin-Induced Thrombocytopenia

被引：25

作者：

Messmore, Harry L. ^{[1
]}

Fabbrini, Nancy ^{[1
]}

Bird, Mary L. ^{[1
]}

Choudhury, Abdul M. ^{[1
]}

Cerejo, Miguel ^{[1
,2
]}

Prechel, Margaret ^{[2
]}

Jeske, Walter P. ^{[2
]}

Siddiqui, Arshea ^{[1
,2
]}

Thethi, Indermohan ^{[1
]}

Wehrmacher, William H. ^{[1
,2
]}

Walenga, Jeanine M. ^{[2
]}

机构：

[1] Edward Hines Vet Adm Med Ctr, Hines, IL USA

[2] Loyola Univ Chicago, Maywood, IL USA

来源：

CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS | 2011年 / 17卷 / 02期

关键词：

thrombocytopenia; heparin; thrombosis; PLATELET-AGGREGATION TEST; SEROTONIN RELEASE ASSAY; CLINICAL-USEFULNESS; DIAGNOSIS; PATHOPHYSIOLOGY;

D O I：

10.1177/1076029610387126

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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), C-14-serotonin release assay (C-14-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.

引用

页码：197 / 201

页数：5

共 19 条

[1]

CHONG BH, 1993, THROMB HAEMOSTASIS, V69, P344

[2] Bacteria-platelet interactions [J].