Detection of Heparin-Induced Thrombocytopenia

Heparin-induced thrombocytopenia (HIT), often with thrombosis, is suspected when the platelet count declines in a patient receiving heparin. Successful management depends on quickly discontinuing all sources of heparin and initiating alternative anticoagulants. However, clinical suspicion and laboratory testing are occasionally inaccurate and could result in continuing thromboses if heparin is continued or bleeding if heparin is exchanged for another anticoagulant.

To improve the diagnostic strategy for HIT, investigators conducted a prospective cohort study in 526 patients suspected of having this disorder. They combined the 4Ts score (thrombocytopenia, time of thrombocytopenia, thrombosis, other causes for thrombosis) with a rapid (1-hour)…