IJCRR - Vol 09 issue 10 current issue , May, 2017
Pages: 28-31
The Incidence of Heparin Induced Thrombocytopenia in Orthopedic Surgery Patients in Khartoum, Sudan
Author: Amar Ibrahim Omer Yahia, Maria Mohamed Hamad Satti
Category: Healthcare
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Abstract:
Aim: The aim of this study was to determine the incidence of low molecular weight heparin (LMWH) induced thrombocytopenia in patients undergoing orthopedic surgery in Khartoum Teaching Hospital. Heparin induced thrombocytopenia (HIT) is a complication of heparin therapy in which the platelet count falls by 50% or more of the baseline value, or falls to below 150×109/L.
Methodology: This is a prospective cross sectional study carried out in Khartoum Teaching Hospital, Department of Orthopedic Surgery in the period between April-July 2013.
Results: Seventy three patients were included, forty nine (67.1%) were males and 24 (32.9%) were females. Most of the patients were between 40-59 years of age (50.7%). Sixty nine (94.52%) of the patients were not exposed to heparin before. All patients received LMWH as prophylaxis except 2 patients who received it for treatment. Fifty patients (68.49%) received LMWH in a dose of 3500 (IU) per day while 23 patients (31.51%) received it in a dose of 4500 IU. Fifty six of the patients received LMWH for 2 weeks, 15 patients for less than 2 weeks while 2 patients for more than 2 weeks. All patients had a baseline platelet count equal or more than 150×109/L. On day 14, none of the patients had 50% reduction or more in the platelet count from the baseline or a platelet count of less than 150×109/L.
Conclusion: The study found that no patient treated with LMWH had significant HIT.
Keywords: Low molecular weight heparin, Khartoum teaching hospital, Baseline platelet count
Citation:
Amar Ibrahim Omer Yahia, Maria Mohamed Hamad Satti. The Incidence of Heparin Induced Thrombocytopenia in Orthopedic Surgery Patients in Khartoum, Sudan International Journal of Current Research and Review. Vol 09 issue 10 current issue , May, 28-31
References:
1. Kaushansky K, Lichtman MA, Beutler E, et al. Williams Hematology. 8th ed. China: The McGraw-Hill Companies; 2010. P. 2685.
2. Warkentin TE. Heparin-induced thrombocytopenia: pathogenesis and management. Br J Haematol 2003; 121:535–555.
3. Warkentin TE. Platelet count monitoring and laboratory testing for heparin-induced thrombocytopenia: recommendations of the College of American Pathologists. Arch Pathol Lab Med 2002; 126:1415–1423.
4. Hoffbrand AV, Catovsky D, Tuddenham EGD, et al. Acquired Venous Thrombosis. In: Hunt BJ, Greaves M. Post graduate Haematology. 6th ed. Chichester: Wiley-Blackwell; 2011. P. 891.
5. Chong BH: Heparin-induced thrombocytopenia. J Thromb Haemost 2003; 1:1471-1478.
6. Jang I-K, Hursting HJ: When heparins promote thrombosis. Review of heparin-induced thrombocytopenia. Circulation 2005; 111:2671-2683.
7. Warkentin TE: Heparin-induced thrombocytopenia. Diagnosis and management. Circulation 2004; 110:e454-458.
8. Cines DB, Bussel JB, McMillan RB, et al: Congenital and acquired thrombocytopenia. Hematology (Am Soc Hematol Educ Program) 2004; 390-406.
9. Warkentin TE, Greinacher A: Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 Suppl): 311S-337S.
10. Kern W. PDQ HEMATOLOGY. 1st ed. US: 1-55009-176-x; 2002. P.197-210.
11. Beck N, Diagnostic Hematology. 1st ed. London: Springer; 2009. P.275.
12. Lee DH, Warkentin TE. Frequency of heparin-induced thrombocytopenia. In:Warkentin TE, Greinacher A, eds. In: Heparin-induced Thrombocytopenia, 3rd ed. New York: Marcel Dekker, Inc., 2004:107–148.
13. Warkentin TE, Levine MN, Hirsh J, et al: Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med 1995; 332:1330.
14. Greinacher A, Eichler P, Lubenow N, et al: Heparin-induced thrombocytopenia with thromboembolic complications: Meta-analysis of 2 prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range. Blood 2000; 96:846.
15. Wallis DE, Workman DL, Lewis BE, et al: Failure of early heparin cessation as treatment for heparin-induced thrombocytopenia. Am J Med1999; 106:629.
16. Colwell CW Jr, Spiro TE, Trowbridge AA, et al. Use of enoxaparin, a lowmolecular-weight heparin, and unfractionated heparin for the prevention of Deep venous thrombosis after elective hip replacement: a clinical trial comparing efficacy and safety. J Bone Joint Surg Am 1994;76:3-14.
17. Leyvraz PF, Bachmann F, Hoek J, et al. Prevention of deep vein thrombosis after hip replacement: randomised comparison between unfractionated heparin and low molecular weight heparin. BMJ 1991;303:543-8.
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