American journal of blood research · 2026
Incidence and mortality of heparin-induced thrombocytopenia in critically Ill patients.
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Chaliki Kalyan, Movahed Mohammad Reza, Hashemzadeh Mehrtash, Hashemzadeh Mehrnoosh
Аннотация
OBJECTIVES: Heparin is widely used as an anticoagulant in hospitals. Ventilated patients on heparin are at a higher risk of developing heparin-induced thrombocytopenia (HIT). This study aims to examine the effect of HIT on mortality in ventilated patients.
METHODS: We used available ICD-10 codes from 2016 to 2020. Patients with specific ICD-10 codes for HIT and ventilator dependence were included. The incidence of HIT in ventilated patients was calculated, and mortality rates were compared between HIT-positive and HIT-negative ventilated patients. For the year 2020, given the presence of COVID, additional multivariate analysis was performed to adjust for baseline characteristics and confounding factors.
RESULTS: We found no significant increase in mortality in patients on ventilation with HIT compared to those without HIT for the years 2016-2019 in the pre-COVID era. However, there was a significant increase in mortality among ventilated patients with HIT in the year 2020 during the first year of the COVID pandemic before vaccination (odds ratio [OR] = 2.03, 95% confidence interval [CI] = 1.26-3.26, P = 0.004). However, after adjusting for age, gender, race, and COVID-19 diagnosis, only COVID-19, but not HIT, showed a significantly higher risk of mortality in ventilated patients with HIT compared to no HIT (OR = 3.80, 95% CI = 3.47-4.15, P < 0.001).
CONCLUSIONS: These findings suggest HIT is not associated with increased mortality among ventilated patients. However, in the year 2020, COVID-19 infection increased the mortality of ventilated patients by almost 4-fold regardless of HIT. This data suggests that HIT is not an independent risk for mortality in ventilated patients.
METHODS: We used available ICD-10 codes from 2016 to 2020. Patients with specific ICD-10 codes for HIT and ventilator dependence were included. The incidence of HIT in ventilated patients was calculated, and mortality rates were compared between HIT-positive and HIT-negative ventilated patients. For the year 2020, given the presence of COVID, additional multivariate analysis was performed to adjust for baseline characteristics and confounding factors.
RESULTS: We found no significant increase in mortality in patients on ventilation with HIT compared to those without HIT for the years 2016-2019 in the pre-COVID era. However, there was a significant increase in mortality among ventilated patients with HIT in the year 2020 during the first year of the COVID pandemic before vaccination (odds ratio [OR] = 2.03, 95% confidence interval [CI] = 1.26-3.26, P = 0.004). However, after adjusting for age, gender, race, and COVID-19 diagnosis, only COVID-19, but not HIT, showed a significantly higher risk of mortality in ventilated patients with HIT compared to no HIT (OR = 3.80, 95% CI = 3.47-4.15, P < 0.001).
CONCLUSIONS: These findings suggest HIT is not associated with increased mortality among ventilated patients. However, in the year 2020, COVID-19 infection increased the mortality of ventilated patients by almost 4-fold regardless of HIT. This data suggests that HIT is not an independent risk for mortality in ventilated patients.