Risk factors for adverse outcomes in patients who were HIT-negative
| Characteristic . | Not fully recovered platelets . | Major bleeding . | Venous thromboembolism . | Arterial thrombosis . | Death . | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n = 1144 . | Exp (Beta) . | 95% CI . | P value . | n = 1172 . | Exp (Beta) . | 95% CI . | P value . | n = 1150 . | Exp (Beta) . | 95% CI . | P value . | n = 1150 . | Exp (Beta) . | 95% CI . | P value . | n = 1175 . | Exp (Beta) . | 95% CI . | P value . | |
| Sex | ||||||||||||||||||||
| Female | 403 | — | — | — | 412 | — | — | — | 403 | — | — | — | 403 | — | — | — | 412 | — | — | — |
| Male | 741 | 1.00 | 0.94-1.06 | >.9 | 760 | 1.05 | 1.01-1.10 | .015 | 747 | 1.01 | 0.98-1.04 | .5 | 747 | 0.99 | 0.97-1.02 | .5 | 763 | 0.98 | 0.93-1.03 | .4 |
| Age less than median | 1144 | 1.05 | 0.99-1.11 | .11 | 1172 | 0.96 | 0.92-1.00 | .044 | 1150 | 0.97 | 0.95-1.00 | .058 | 1150 | 1.00 | 0.97-1.02 | .8 | 1175 | 1.05 | 1.00-1.10 | .034 |
| Setting | ||||||||||||||||||||
| Postoperative general surgery and orthopedics | 108 | — | — | — | 110 | — | — | — | 105 | — | — | — | 105 | — | — | — | 110 | — | — | — |
| Postoperative cardiac and vascular surgery | 377 | 1.05 | 0.94-1.17 | .4 | 383 | 1.03 | 0.96-1.11 | .4 | 374 | 0.93 | 0.88-0.98 | .012 | 374 | 1.03 | 0.98-1.08 | .3 | 383 | 0.97 | 0.89-1.06 | .5 |
| Internal medicine | 219 | 1.25 | 1.12-1.39 | <.001 | 227 | 0.98 | 0.91-1.06 | .7 | 226 | 0.94 | 0.89-1.00 | .037 | 226 | 1.01 | 0.96-1.06 | .8 | 228 | 0.98 | 0.90-1.08 | .7 |
| ICU | 428 | 1.19 | 1.07-1.31 | .001 | 438 | 1.04 | 0.97-1.12 | .3 | 431 | 0.97 | 0.92-1.02 | .3 | 431 | 1.02 | 0.97-1.07 | .4 | 440 | 1.15 | 1.05-1.25 | .001 |
| Major trauma | 4 | 0.84 | 0.52-1.36 | .5 | 4 | 1.12 | 0.80-1.58 | .5 | 4 | 0.90 | 0.71-1.15 | .4 | 4 | 0.97 | 0.78-1.21 | .8 | 4 | 0.87 | 0.59-1.29 | .5 |
| Other | 8 | 1.19 | 0.85-1.68 | .3 | 10 | 0.93 | 0.74-1.16 | .5 | 10 | 0.91 | 0.78-1.07 | .3 | 10 | 0.98 | 0.85-1.13 | .8 | 10 | 0.90 | 0.70-1.17 | .4 |
| Sepsis | ||||||||||||||||||||
| No | 582 | — | — | — | 600 | — | — | — | 592 | — | — | — | 592 | — | — | — | 602 | — | — | — |
| Yes | 562 | 1.01 | 0.95-1.07 | .8 | 572 | 1.02 | 0.97-1.06 | .5 | 558 | 1.03 | 1.00-1.06 | .080 | 558 | 1.01 | 0.98-1.03 | .7 | 573 | 1.04 | 0.99-1.10 | .083 |
| Chemotherapy | ||||||||||||||||||||
| No | 1037 | — | — | — | 1060 | — | — | — | 1038 | — | — | — | 1036 | — | — | — | 1062 | — | — | — |
| Yes | 107 | 1.12 | 1.01-1.24 | .026 | 112 | 0.98 | 0.91-1.05 | .5 | 112 | 0.97 | 0.92-1.02 | .2 | 112 | 0.98 | 0.93-1.02 | .3 | 113 | 1.14 | 1.05-1.23 | .001 |
| Hb >12 g/L | 1144 | 1.07 | 0.97 1.17 | .2 | 1172 | 0.92 | 0.86-0.98 | .009 | 1150 | 0.97 | 0.93-1.01 | .2 | 1150 | 0.98 | 0.94-1.02 | .2 | 1175 | 0.91 | 0.84-0.98 | .009 |
| WBC >10 × 109/L | 1144 | 0.94 | 0.88-0.99 | .024 | 1172 | 1.09 | 1.05-1.14 | <.001 | 1150 | 1.03 | 1.00-1.06 | .053 | 1150 | 1.05 | 1.03-1.08 | <.001 | 1175 | 1.13 | 1.08-1.18 | <.001 |
| Platelet nadir >50 × 109/L | 1144 | 1.17 | 1.10-1.24 | <.001 | 1172 | 0.97 | 0.93-1.01 | .11 | 1150 | 1.00 | 0.97-1.03 | .8 | 1150 | 0.98 | 0.96-1.01 | .2 | 1175 | 0.94 | 0.90-0.99 | .016 |
| AcuStar HIT | ||||||||||||||||||||
| Negative | 1076 | — | — | — | 1103 | — | — | — | 1083 | — | — | — | 1083 | — | — | — | 1106 | — | — | — |
| Positive | 68 | 1.02 | 0.87-1.18 | .8 | 69 | 0.97 | 0.87-1.07 | .5 | 67 | 0.98 | 0.91-1.06 | .7 | 67 | 1.01 | 0.94-1.08 | .9 | 69 | 0.93 | 0.83-1.06 | .3 |
| Anticoagulation therapy | ||||||||||||||||||||
| No alternative anticoagulant | 988 | — | — | — | 1012 | — | — | — | 994 | — | — | — | 994 | — | — | — | 1015 | — | — | — |
| DOAC only | 22 | 1.07 | 0.087-1.32 | .5 | 22 | 0.91 | 0.78-1.05 | .2 | 22 | 1.04 | 0.94-1.15 | .5 | 22 | 1.02 | 0.93-1.12 | .7 | 22 | 0.93 | 0.79-1.10 | .4 |
| Fondaparinux only | 43 | 0.88 | 0.76-1.02 | .10 | 44 | 0.96 | 0.86-1.06 | .4 | 43 | 0.96 | 0.89-1.04 | .3 | 43 | 0.99 | 0.93-1.06 | .8 | 44 | 0.88 | 0.78-0.99 | .036 |
| Bivalirudin | 8 | 0.97 | 0.69-1.36 | .9 | 8 | 1.00 | 0.78-1.27 | >.9 | 8 | 1.10 | 0.93-1.31 | .3 | 8 | 0.95 | 0.81-1.11 | .5 | 8 | 1.14 | 0.51-1.15 | .4 |
| Argatroban | 83 | 1.01 | 0.88-1.15 | >.9 | 86 | 0.97 | 0.88-1.06 | .5 | 83 | 1.11 | 1.03-1.18 | .003 | 83 | 1.06 | 1.00-1.13 | .046 | 86 | 1.01 | 0.91-1.13 | .8 |
| Characteristic . | Not fully recovered platelets . | Major bleeding . | Venous thromboembolism . | Arterial thrombosis . | Death . | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n = 1144 . | Exp (Beta) . | 95% CI . | P value . | n = 1172 . | Exp (Beta) . | 95% CI . | P value . | n = 1150 . | Exp (Beta) . | 95% CI . | P value . | n = 1150 . | Exp (Beta) . | 95% CI . | P value . | n = 1175 . | Exp (Beta) . | 95% CI . | P value . | |
| Sex | ||||||||||||||||||||
| Female | 403 | — | — | — | 412 | — | — | — | 403 | — | — | — | 403 | — | — | — | 412 | — | — | — |
| Male | 741 | 1.00 | 0.94-1.06 | >.9 | 760 | 1.05 | 1.01-1.10 | .015 | 747 | 1.01 | 0.98-1.04 | .5 | 747 | 0.99 | 0.97-1.02 | .5 | 763 | 0.98 | 0.93-1.03 | .4 |
| Age less than median | 1144 | 1.05 | 0.99-1.11 | .11 | 1172 | 0.96 | 0.92-1.00 | .044 | 1150 | 0.97 | 0.95-1.00 | .058 | 1150 | 1.00 | 0.97-1.02 | .8 | 1175 | 1.05 | 1.00-1.10 | .034 |
| Setting | ||||||||||||||||||||
| Postoperative general surgery and orthopedics | 108 | — | — | — | 110 | — | — | — | 105 | — | — | — | 105 | — | — | — | 110 | — | — | — |
| Postoperative cardiac and vascular surgery | 377 | 1.05 | 0.94-1.17 | .4 | 383 | 1.03 | 0.96-1.11 | .4 | 374 | 0.93 | 0.88-0.98 | .012 | 374 | 1.03 | 0.98-1.08 | .3 | 383 | 0.97 | 0.89-1.06 | .5 |
| Internal medicine | 219 | 1.25 | 1.12-1.39 | <.001 | 227 | 0.98 | 0.91-1.06 | .7 | 226 | 0.94 | 0.89-1.00 | .037 | 226 | 1.01 | 0.96-1.06 | .8 | 228 | 0.98 | 0.90-1.08 | .7 |
| ICU | 428 | 1.19 | 1.07-1.31 | .001 | 438 | 1.04 | 0.97-1.12 | .3 | 431 | 0.97 | 0.92-1.02 | .3 | 431 | 1.02 | 0.97-1.07 | .4 | 440 | 1.15 | 1.05-1.25 | .001 |
| Major trauma | 4 | 0.84 | 0.52-1.36 | .5 | 4 | 1.12 | 0.80-1.58 | .5 | 4 | 0.90 | 0.71-1.15 | .4 | 4 | 0.97 | 0.78-1.21 | .8 | 4 | 0.87 | 0.59-1.29 | .5 |
| Other | 8 | 1.19 | 0.85-1.68 | .3 | 10 | 0.93 | 0.74-1.16 | .5 | 10 | 0.91 | 0.78-1.07 | .3 | 10 | 0.98 | 0.85-1.13 | .8 | 10 | 0.90 | 0.70-1.17 | .4 |
| Sepsis | ||||||||||||||||||||
| No | 582 | — | — | — | 600 | — | — | — | 592 | — | — | — | 592 | — | — | — | 602 | — | — | — |
| Yes | 562 | 1.01 | 0.95-1.07 | .8 | 572 | 1.02 | 0.97-1.06 | .5 | 558 | 1.03 | 1.00-1.06 | .080 | 558 | 1.01 | 0.98-1.03 | .7 | 573 | 1.04 | 0.99-1.10 | .083 |
| Chemotherapy | ||||||||||||||||||||
| No | 1037 | — | — | — | 1060 | — | — | — | 1038 | — | — | — | 1036 | — | — | — | 1062 | — | — | — |
| Yes | 107 | 1.12 | 1.01-1.24 | .026 | 112 | 0.98 | 0.91-1.05 | .5 | 112 | 0.97 | 0.92-1.02 | .2 | 112 | 0.98 | 0.93-1.02 | .3 | 113 | 1.14 | 1.05-1.23 | .001 |
| Hb >12 g/L | 1144 | 1.07 | 0.97 1.17 | .2 | 1172 | 0.92 | 0.86-0.98 | .009 | 1150 | 0.97 | 0.93-1.01 | .2 | 1150 | 0.98 | 0.94-1.02 | .2 | 1175 | 0.91 | 0.84-0.98 | .009 |
| WBC >10 × 109/L | 1144 | 0.94 | 0.88-0.99 | .024 | 1172 | 1.09 | 1.05-1.14 | <.001 | 1150 | 1.03 | 1.00-1.06 | .053 | 1150 | 1.05 | 1.03-1.08 | <.001 | 1175 | 1.13 | 1.08-1.18 | <.001 |
| Platelet nadir >50 × 109/L | 1144 | 1.17 | 1.10-1.24 | <.001 | 1172 | 0.97 | 0.93-1.01 | .11 | 1150 | 1.00 | 0.97-1.03 | .8 | 1150 | 0.98 | 0.96-1.01 | .2 | 1175 | 0.94 | 0.90-0.99 | .016 |
| AcuStar HIT | ||||||||||||||||||||
| Negative | 1076 | — | — | — | 1103 | — | — | — | 1083 | — | — | — | 1083 | — | — | — | 1106 | — | — | — |
| Positive | 68 | 1.02 | 0.87-1.18 | .8 | 69 | 0.97 | 0.87-1.07 | .5 | 67 | 0.98 | 0.91-1.06 | .7 | 67 | 1.01 | 0.94-1.08 | .9 | 69 | 0.93 | 0.83-1.06 | .3 |
| Anticoagulation therapy | ||||||||||||||||||||
| No alternative anticoagulant | 988 | — | — | — | 1012 | — | — | — | 994 | — | — | — | 994 | — | — | — | 1015 | — | — | — |
| DOAC only | 22 | 1.07 | 0.087-1.32 | .5 | 22 | 0.91 | 0.78-1.05 | .2 | 22 | 1.04 | 0.94-1.15 | .5 | 22 | 1.02 | 0.93-1.12 | .7 | 22 | 0.93 | 0.79-1.10 | .4 |
| Fondaparinux only | 43 | 0.88 | 0.76-1.02 | .10 | 44 | 0.96 | 0.86-1.06 | .4 | 43 | 0.96 | 0.89-1.04 | .3 | 43 | 0.99 | 0.93-1.06 | .8 | 44 | 0.88 | 0.78-0.99 | .036 |
| Bivalirudin | 8 | 0.97 | 0.69-1.36 | .9 | 8 | 1.00 | 0.78-1.27 | >.9 | 8 | 1.10 | 0.93-1.31 | .3 | 8 | 0.95 | 0.81-1.11 | .5 | 8 | 1.14 | 0.51-1.15 | .4 |
| Argatroban | 83 | 1.01 | 0.88-1.15 | >.9 | 86 | 0.97 | 0.88-1.06 | .5 | 83 | 1.11 | 1.03-1.18 | .003 | 83 | 1.06 | 1.00-1.13 | .046 | 86 | 1.01 | 0.91-1.13 | .8 |
This table presents multivariable regression models assessing factors associated with adverse outcomes during the clinical course in patients with suspected HIT but negative functional testing. Regression coefficients and 95% CIs are reported (a coefficient of 1 indicates no effect).