Comparison of Screening Scores for Heparin- Induced Thrombocytopenia After Cardiopulmonary Bypass

OBJECTIVES: To compare screening scores for heparin-induced thrombocytopenia (HIT) after cardiopulmonary bypass (CPB). DESIGN: Retrospective cohort study. SETTING: Cardiothoracic surgery units within a large tertiary healthcare facility from September 2010 to January 2020. PARTICIPANTS: All adult patients tested for heparin-induced platelet antibody (HIPA) within 2 weeks after surgery requiring CPB. INTERVENTIONS: Using data available to providers at the time HIPA were checked, the 4T's Score, a modified 4T's Score, and a score proposed by Lillo-Le Louet (LLL) et al. were calculated. A retrospective chart review was performed for each patient to determine actual presence of HIT, and screening scores were compared for accuracy. MEASUREMENTS AND MAIN RESULTS: Criteria for inclusion were met in 266 patients. Of these, 34 (12.8%) were high likelihood of HIT, 16 (6.0%), additional patients were clinically ambiguous, and 216 (81.2%) were high likelihood of alternative cause for thrombocytopenia. HIPA tests done before postoperative day 5 were not associated with any high-likelihood cases of HIT regardless of preoperative heparin exposure. Although traditional 4T's ≥4, modified 4T's ≥3, and LLL ≥2 had statistically similar sensitivity for predicting HIT, the modified 4T's and LLL had superior specificity (p < 0.001). CONCLUSIONS: Appropriate screening for HIT curbed inappropriate HIPA testing, and reduced the need for empirical treatment while awaiting confirmatory test results. Traditional 4T's was statistically inferior to both the LLL score and a modified version of the 4T's to screen for HIT within 2 weeks of CPB.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Explore cómo esta investigación se conecta con la práctica clínica

More peer-reviewed studies in Ensayos clínicos.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →