Heparin-Induced Thrombocytopenia After Cardiac Surgery-A Statewide Review of Health Care Utilization.

Autor:	Yesantharao LV; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Etchill EW; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Canner J; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Alejo D; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Choi CW; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Lawton JS; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Sussman M; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland., Schena S; Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: sschena1@jhmi.edu.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2024 Jan; Vol. 117 (1), pp. 221-228. Date of Electronic Publication: 2022 Aug 18.
DOI:	10.1016/j.athoracsur.2022.07.049
Abstrakt:	Background: Despite its severe consequences, clinical and economic impacts of heparin-induced thrombocytopenia (HIT) after cardiac operations have not been well characterized. This study assessed statewide incidence, outcomes, and resource consumption associated with HIT after cardiac operations. Methods: This was a retrospective investigation of cardiac surgery patients using the Maryland Health Services Cost Review Commission's database from 2012 to 2020. Health care costs, utilization, and outcomes for those who experienced postoperative HIT were compared with propensity score-matched controls. Results: Of 33 583 cardiac surgery patients, 184 (0.55%) were diagnosed with postoperative HIT. Compared with non-HIT patients, HIT patients were significantly more likely to be in the oldest age group (>80 years; P < .001) and to have greater severity of illness at admission (P < .001). HIT was associated with a longer hospitalization (21 vs 7 days; P < .001), greater mortality (13.6% vs 2.3%; P < .001), and greater hospital charges ($123 160 vs $45 303; P < .001), even after propensity score matching. Readmission rates were not significantly different, however, and readmission hospital charges did not significantly differ between HIT and non-HIT patients. Conclusions: In addition to worse outcomes, HIT was associated with higher costs during index admissions but not during readmissions of cardiac surgery patients. Strategies to minimize HIT could yield better outcomes and reduced costs, particularly relevant for health care systems seeking improved value-based care while reducing unnecessary hospitalizations. (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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