HEPARIN-INDUCED THROMBOCYTOPENIA AND ITS IMPACT ON INPATIENT OUTCOMES IN INFLAMMATORY BOWEL DISEASE

Hospitalizations with inflammatory bowel disease (IBD) are at increased risk of venous thromboembolism (VTE), and current guidelines recommend routine pharmacological thromboprophylaxis during admission. However, there is limited evidence regarding the occurrence of Heparin-induced thrombocytopenia (HIT) in this population. We examined the incidence and risk of HIT among hospitalizations with IBD.

A retrospective cohort study using the National Inpatient Sample dataset spanning ten years. We identified the predictive factors of HIT and assessed its impact on inpatient outcomes of IBD hospitalizations. We included hospitalizations aged ≥18 years with any discharge diagnosis (primary or secondary) of IBD, identified using ICD-CM codes.

Among 3,093,632 hospitalizations with IBD, 2,218 (0.07%) were diagnosed with HIT. IBD hospitalizations had 40% higher odds of developing HIT (AOR: 1.42; 95% CI: 1.28-1.56). Compared with those without HIT, IBD hospitalizations with HIT had higher odds of mortality (AOR: 3.23; 95% CI: 2.21-4.74), longer mean length of stay (β: 7.3, 95% CI: 6.07-8.49), and higher mean total hospital charges (β: $97,211, 95% CI: $83,540-$129,417). Additionally, they had increased odds of both venous and arterial thromboembolic events, as well as significant bleeding events.

Hospitalizations with IBD had increased risk of HIT, which is subsequently associated with worse in-hospital outcomes. While recognizing the benefits of VTE prophylaxis in this population, further investigation is necessary to better understand the observed risk of HIT. Utilizing innovative methods, such as clinical decision support tools combined with established HIT prevention and management practices, may help improve patient outcomes.