Risk factors for adverse outcomes in patients with confirmed HIT
| Characteristic . | Not fully recovered platelets . | Major bleeding . | Venous thromboembolism . | Arterial thrombosis . | Death . | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n = 102 . | Exp (Beta) . | 95% CI . | P value . | n = 106 . | Exp (Beta) . | 95% CI . | P value . | n = 105 . | Exp (Beta) . | 95% CI . | P value . | n = 105 . | Exp (Beta) . | 95% CI . | P value . | n = 106 . | Exp (Beta) . | 95% CI . | P value . | |
| Sex | ||||||||||||||||||||
| Female | 40 | — | — | — | 43 | — | — | — | 42 | — | — | — | 42 | — | — | — | 43 | — | — | — |
| Male | 62 | 1.09 | 0.92-1.31 | .3 | 63 | 1.05 | 0.91-1.20 | .5 | 63 | 1.29 | 1.08-1.53 | .006 | 63 | 1.02 | 0.91-1.15 | .7 | 63 | 1.00 | 0.85-1.17 | >.9 |
| Age less than median | 102 | 1.08 | 0.91-1.30 | .4 | 106 | 0.97 | 0.85-1.12 | .7 | 105 | 1.06 | 0.89-1.26 | .5 | 105 | 0.98 | 0.87-1.10 | .7 | 106 | 1.14 | 0.97-1.34 | .10 |
| Setting | ||||||||||||||||||||
| Postoperative general surgery and orthopedics | 6 | — | — | — | 6 | — | — | — | 6 | — | — | — | 6 | — | — | — | 6 | — | — | — |
| Postoperative cardiac and vascular surgery | 40 | 0.92 | 0.63-1.34 | .7 | 42 | 0.80 | 0.59-1.08 | .14 | 42 | 1.05 | 0.72-1.52 | .8 | 42 | 1.18 | 0.91-1.52 | .2 | 42 | 0.99 | 0.70-1.39 | >.9 |
| Internal medicine | 13 | 1.23 | 0.80-1.88 | .3 | 13 | 0.85 | 0.61-1.20 | .4 | 13 | 0.86 | 0.56-1.32 | .5 | 13 | 1.02 | 0.76-1.36 | >.9 | 13 | 1.00 | 0.68-1.47 | >.9 |
| ICU | 37 | 1.18 | 0.81-1.73 | .4 | 38 | 0.74 | 0.55-0.99 | .049 | 37 | 1.14 | 0.78-1.66 | .5 | 37 | 1.03 | 0.80-1.33 | .8 | 38 | 0.98 | 0.69-1.38 | .9 |
| Major trauma | 6 | 0.84 | 0.51-1.38 | .5 | 6 | 0.65 | 0.44-0.97 | .037 | 6 | 0.75 | 0.45-1.23 | .3 | 6 | 0.92 | 0.65-1.30 | .6 | 6 | 0.88 | 0.56-1.38 | .6 |
| Other | 1 | 1.21 | 0.48-3.09 | .7 | 1 | 1.08 | 0.57-2.04 | .8 | 1 | 1.15 | 0.49-2.71 | .7 | 1 | 1.15 | 0.49-2.71 | .7 | ||||
| Sepsis | ||||||||||||||||||||
| No | 49 | — | — | — | 52 | — | — | — | 51 | — | — | — | 51 | — | — | — | 52 | — | — | — |
| Yes | 53 | 1.05 | 0.88-1.26 | .6 | 54 | 1.15 | 1.01-1.32 | .043 | 54 | 1.02 | 0.86-1.22 | .8 | 54 | 1.01 | 0.89-1.13 | >.9 | 54 | 1.14 | 0.97-1.33 | .11 |
| Chemotherapy | ||||||||||||||||||||
| No | 98 | — | — | — | 102 | — | — | — | 101 | — | — | — | 101 | — | — | — | 102 | — | — | — |
| Yes | 4 | 0.65 | 0.41-1.01 | .060 | 4 | 0.91 | 0.64-1.30 | .6 | 4 | 0.77 | 0.49-1.21 | .3 | 4 | 0.99 | 0.73-1.34 | >.9 | 4 | 1.05 | 0.70-1.57 | .8 |
| Hb >12 g/L | 102 | 0.94 | 0.64-1.38 | .7 | 106 | 0.92 | 0.67-1.25 | .6 | 105 | 0.88 | 0.60-1.30 | .5 | 105 | 0.92 | 0.70-1.20 | .5 | 106 | 1.05 | 0.74-1.50 | .8 |
| WBC >10 × 109/L | 102 | 1.12 | 0.93-1.35 | .2 | 106 | 1.05 | 0.91-1.21 | .5 | 105 | 1.01 | 0.84-1.22 | .9 | 105 | 1.02 | 0.90-1.16 | .7 | 106 | 1.11 | 0.94-1.30 | .2 |
| Platelet nadir >50 × 109/L | 102 | 1.02 | 0.86-1.21 | .8 | 106 | 1.01 | 0.89-1.16 | .8 | 105 | 0.97 | 0.82-1.14 | .7 | 105 | 0.99 | 0.89-1.11 | .9 | 106 | 0.87 | 0.75-1.01 | .068 |
| AcuStar HIT per U/mL | 102 | 1.00 | 1.00-1.00 | .2 | 106 | 1.00 | 1.00-1.00 | >.9 | 105 | 1.00 | 1.00-1.00 | .3 | 105 | 1.00 | 1.00-1.00 | .7 | 106 | 1.00 | 1.00-1.00 | .6 |
| Anticoagulation therapy | ||||||||||||||||||||
| No alternative anticoagulant | 6 | — | — | — | 7 | — | — | — | 6 | — | — | — | 6 | — | — | — | 7 | — | — | — |
| DOAC only | 3 | 1.15 | 0.63-2.10 | .6 | 4 | 0.79 | 0.52-1.21 | .3 | 4 | 0.96 | 0.56-1.65 | .9 | 4 | 0.59 | 0.41-0.86 | .007 | 4 | 0.63 | 0.39-1.01 | .058 |
| Fondaparinux only | 8 | 0.83 | 0.52-1.33 | .4 | 10 | 0.63 | 0.45-0.89 | .011 | 10 | 1.04 | 0.66-1.64 | .9 | 10 | 0.62 | 0.45-0.84 | .003 | 10 | 0.73 | 0.49-1.09 | .13 |
| Bivalirudin | 9 | 0.81 | 0.51-1.29 | .4 | 9 | 0.70 | 0.49-1.00 | .054 | 9 | 1.31 | 0.82-2.08 | .3 | 9 | 0.60 | 0.44-0.83 | .002 | 9 | 0.76 | 0.51-1.15 | .2 |
| Argatroban | 76 | 0.79 | 0.55-1.15 | .2 | 76 | 0.71 | 0.54-0.93 | .017 | 76 | 1.38 | 0.96-2.00 | .085 | 76 | 0.67 | 0.52-0.86 | .002 | 76 | 0.80 | 0.58-1.09 | .2 |
| Characteristic . | Not fully recovered platelets . | Major bleeding . | Venous thromboembolism . | Arterial thrombosis . | Death . | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n = 102 . | Exp (Beta) . | 95% CI . | P value . | n = 106 . | Exp (Beta) . | 95% CI . | P value . | n = 105 . | Exp (Beta) . | 95% CI . | P value . | n = 105 . | Exp (Beta) . | 95% CI . | P value . | n = 106 . | Exp (Beta) . | 95% CI . | P value . | |
| Sex | ||||||||||||||||||||
| Female | 40 | — | — | — | 43 | — | — | — | 42 | — | — | — | 42 | — | — | — | 43 | — | — | — |
| Male | 62 | 1.09 | 0.92-1.31 | .3 | 63 | 1.05 | 0.91-1.20 | .5 | 63 | 1.29 | 1.08-1.53 | .006 | 63 | 1.02 | 0.91-1.15 | .7 | 63 | 1.00 | 0.85-1.17 | >.9 |
| Age less than median | 102 | 1.08 | 0.91-1.30 | .4 | 106 | 0.97 | 0.85-1.12 | .7 | 105 | 1.06 | 0.89-1.26 | .5 | 105 | 0.98 | 0.87-1.10 | .7 | 106 | 1.14 | 0.97-1.34 | .10 |
| Setting | ||||||||||||||||||||
| Postoperative general surgery and orthopedics | 6 | — | — | — | 6 | — | — | — | 6 | — | — | — | 6 | — | — | — | 6 | — | — | — |
| Postoperative cardiac and vascular surgery | 40 | 0.92 | 0.63-1.34 | .7 | 42 | 0.80 | 0.59-1.08 | .14 | 42 | 1.05 | 0.72-1.52 | .8 | 42 | 1.18 | 0.91-1.52 | .2 | 42 | 0.99 | 0.70-1.39 | >.9 |
| Internal medicine | 13 | 1.23 | 0.80-1.88 | .3 | 13 | 0.85 | 0.61-1.20 | .4 | 13 | 0.86 | 0.56-1.32 | .5 | 13 | 1.02 | 0.76-1.36 | >.9 | 13 | 1.00 | 0.68-1.47 | >.9 |
| ICU | 37 | 1.18 | 0.81-1.73 | .4 | 38 | 0.74 | 0.55-0.99 | .049 | 37 | 1.14 | 0.78-1.66 | .5 | 37 | 1.03 | 0.80-1.33 | .8 | 38 | 0.98 | 0.69-1.38 | .9 |
| Major trauma | 6 | 0.84 | 0.51-1.38 | .5 | 6 | 0.65 | 0.44-0.97 | .037 | 6 | 0.75 | 0.45-1.23 | .3 | 6 | 0.92 | 0.65-1.30 | .6 | 6 | 0.88 | 0.56-1.38 | .6 |
| Other | 1 | 1.21 | 0.48-3.09 | .7 | 1 | 1.08 | 0.57-2.04 | .8 | 1 | 1.15 | 0.49-2.71 | .7 | 1 | 1.15 | 0.49-2.71 | .7 | ||||
| Sepsis | ||||||||||||||||||||
| No | 49 | — | — | — | 52 | — | — | — | 51 | — | — | — | 51 | — | — | — | 52 | — | — | — |
| Yes | 53 | 1.05 | 0.88-1.26 | .6 | 54 | 1.15 | 1.01-1.32 | .043 | 54 | 1.02 | 0.86-1.22 | .8 | 54 | 1.01 | 0.89-1.13 | >.9 | 54 | 1.14 | 0.97-1.33 | .11 |
| Chemotherapy | ||||||||||||||||||||
| No | 98 | — | — | — | 102 | — | — | — | 101 | — | — | — | 101 | — | — | — | 102 | — | — | — |
| Yes | 4 | 0.65 | 0.41-1.01 | .060 | 4 | 0.91 | 0.64-1.30 | .6 | 4 | 0.77 | 0.49-1.21 | .3 | 4 | 0.99 | 0.73-1.34 | >.9 | 4 | 1.05 | 0.70-1.57 | .8 |
| Hb >12 g/L | 102 | 0.94 | 0.64-1.38 | .7 | 106 | 0.92 | 0.67-1.25 | .6 | 105 | 0.88 | 0.60-1.30 | .5 | 105 | 0.92 | 0.70-1.20 | .5 | 106 | 1.05 | 0.74-1.50 | .8 |
| WBC >10 × 109/L | 102 | 1.12 | 0.93-1.35 | .2 | 106 | 1.05 | 0.91-1.21 | .5 | 105 | 1.01 | 0.84-1.22 | .9 | 105 | 1.02 | 0.90-1.16 | .7 | 106 | 1.11 | 0.94-1.30 | .2 |
| Platelet nadir >50 × 109/L | 102 | 1.02 | 0.86-1.21 | .8 | 106 | 1.01 | 0.89-1.16 | .8 | 105 | 0.97 | 0.82-1.14 | .7 | 105 | 0.99 | 0.89-1.11 | .9 | 106 | 0.87 | 0.75-1.01 | .068 |
| AcuStar HIT per U/mL | 102 | 1.00 | 1.00-1.00 | .2 | 106 | 1.00 | 1.00-1.00 | >.9 | 105 | 1.00 | 1.00-1.00 | .3 | 105 | 1.00 | 1.00-1.00 | .7 | 106 | 1.00 | 1.00-1.00 | .6 |
| Anticoagulation therapy | ||||||||||||||||||||
| No alternative anticoagulant | 6 | — | — | — | 7 | — | — | — | 6 | — | — | — | 6 | — | — | — | 7 | — | — | — |
| DOAC only | 3 | 1.15 | 0.63-2.10 | .6 | 4 | 0.79 | 0.52-1.21 | .3 | 4 | 0.96 | 0.56-1.65 | .9 | 4 | 0.59 | 0.41-0.86 | .007 | 4 | 0.63 | 0.39-1.01 | .058 |
| Fondaparinux only | 8 | 0.83 | 0.52-1.33 | .4 | 10 | 0.63 | 0.45-0.89 | .011 | 10 | 1.04 | 0.66-1.64 | .9 | 10 | 0.62 | 0.45-0.84 | .003 | 10 | 0.73 | 0.49-1.09 | .13 |
| Bivalirudin | 9 | 0.81 | 0.51-1.29 | .4 | 9 | 0.70 | 0.49-1.00 | .054 | 9 | 1.31 | 0.82-2.08 | .3 | 9 | 0.60 | 0.44-0.83 | .002 | 9 | 0.76 | 0.51-1.15 | .2 |
| Argatroban | 76 | 0.79 | 0.55-1.15 | .2 | 76 | 0.71 | 0.54-0.93 | .017 | 76 | 1.38 | 0.96-2.00 | .085 | 76 | 0.67 | 0.52-0.86 | .002 | 76 | 0.80 | 0.58-1.09 | .2 |
This table presents multivariable regression models identifying risk factors for major adverse outcomes during the clinical course, including incomplete platelet recovery, venous and arterial thromboembolism, major bleeding, and mortality. Regression coefficients and 95% CIs are reported (a coefficient of 1 indicates no effect). Treatment with alternative anticoagulants was significantly associated with a lower risk of subsequent arterial thromboembolism.
CI, confidence interval; Hb, hemoglobin; ICU, intensive care unit; WBC, white blood cell.