In-Hospital Mortality of Heparin-Induced Thrombocytopenia in End-Stage Renal Disease: A Retrospective National Population-Based Cohort Study

Abstract

Background HIT and ESRD are independent conditions associated with increased mortality and morbidity. With the use of unfractionated heparin in ESRD, these patients are at an increased risk of HIT. We aim to bring forth the trends of Heparin-Induced thrombocytopenia hospitalization with or without ESRD and compare in-hospital mortality in these groups using data from the National inpatient sample from 2016 to 2019. Methods A retrospective cohort of HIT hospitalizations aged 18 and older using the 2016-2019 National Inpatient Sample (NIS) was studied. We used STATA for the analysis of data. Results Our study revealed 42.7 HIT hospitalizations per 100,000 individuals hospitalized. The rates per Year for annual incidence were 47, 46, 41.1, and 36.6, respectively (p<0.001) in 2016, 2017, 2018, and 2019 respectively. The prevalence of ESRD per 100,000 hospitalizations per year (from 2016 to 2019) was: 2970.5, 3049.8, 3157.2, and 3245.9, respectively (p<0.001). The results suggested that older HIT patients (aOR 1.02; 95% CI: 1.02, 1.03; p<0.001) have a significantly higher likelihood of in-hospital mortality than younger patients. Among HIT hospitalization, Black patients have a significantly higher likelihood of in-hospital mortality than White patients (aOR 1.25; 95% CI: 1.06, 1.48; p=0.007). Patients who didn't have insurance or self-pay had higher mortality than Medicare (aOR 1.64; 95% CI: 1.13, 2.38; p=0.009). Conclusions There are no higher odds of in-hospital mortality in ESRD than non-ESRD in HIT adult patients. A decreasing incidence of HIT hospitalizations over the years from 2016-to 2019 was seen. Keywords: ESRD, HIT,in-patient mortality, NIS, Survival.