In‐hospital mortality of heparin‐induced thrombocytopenia in end‐stage kidney disease. A retrospective national population‐based cohort study. Issue 3 (4th January 2023)

• Record Type: Journal Article
• Authors: Ghimire, Calvin; Baral, Nischit; Vinjam, Tejaswi; Mathews, Simi M.; Baral, Nisha; Acharya, Bandana; Savarapu, Pramod K.; Bashyal, Krishna; Kunadi, Arvind; Mitchell, Joshua D.
• Is Part Of: Nephrology. Volume 28:Issue 3(2023)
• Page Start: 168
• Page End: 174
• Publication Date: 2023-01-04
• Subjects: end stage kidney disease -- heparin induced thrombocytopenia -- in‐hospital mortality -- national inpatient sample; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.14138
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Aim: Heparin induced thrombocytopenia (HIT) and end stage kidney disease (ESKD) are independent conditions associated with increased mortality and morbidity, however, whether ESKD is an independent risk factor for increased mortality in HIT admissions is not well studied. Therefore, we aimed to compare in‐hospital mortality in HIT admissions based on their ESKD status. Methods: This is a retrospective cohort study of HIT hospitalizations aged 18 and older using the 2016–2019 national inpatient sample (NIS) database. Results: From 2016 to 2019 we had 12 161 admissions for HIT among 28 484 087 total hospitalizations. The annual incidence rate for HIT admissions per 100 000 admissions were: 47, 46, 41.1, and 36.6, respectively ( p < .001) in 2016, 2017, 2018, and 2019 respectively. Among HIT admissions, the mean age was 64.3 years, 46.8% were females, 68% were Whites and 16% were Blacks. Black patients have a significantly higher likelihood of in‐hospital mortality than White patients (aOR 1.25; 95% CI: 1.06, 1.48; p = .007). Patients who did not have any insurance or self‐pay had higher mortality compared to Medicare (aOR 1.64; 95% CI: 1.13, 2.38; p = .009). ESKD status was not associated with higher or lower in‐hospital mortality among HIT admissions (aOR 1.002; 95% CI: 0.84, 1.19; p = .981) after adjusting for age, sex, race, and insurance status. Conclusion: There are no higher or lower odds of in‐hospital mortality in the ESKD subgroup in HIT admissions in adults. Decreasing incidence of HIT hospitalizations was seen over the years from 2016 to 2019. Summary at a Glance: Our study demonstrated that, among adult patients with HIT, there are no higher or lower odds of in‐hospital mortality in ESKD compared to non‐ESKD. There is decreasing incidence of HIT hospitalizations in both the general population and ESKD population from 2016 to 2019. Future studies are needed to highlight the quality of care of ESKD patients and on preventing HIT in ESKD patients undergoing haemodialysis.