Attributable Healthcare Cost and Length of Hospital Stay Associated with Heparin-Induced Thrombocytopenia

Background: Heparin-induced thrombocytopenia (HIT) is a serious adverse drug reaction associated with an increased length of hospital stay (LOS) and utilization of healthcare services and even more so if heparin-induced thrombotic thrombocytopenia (HITT) occurs. Objective: To determine the attributable healthcare cost and LOS of patients experiencing HIT compared with control subjects. Methods: A retrospective case-control study conducted in hospitalized patients with HIT and their control subjects from January 1to December 31, 2013. Of the 462 HIT assay performed, 29 HIT cases and 141 matched control subjects were evaluated. Healthcare costs elements attributed to HIT included laboratory tests, non-heparin anticoagulant, medical imaging, physician visits and LOS. The healthcare costs and LOS of cases, HIT and HITT, and control subjects were determined in US$, year 2013. Result: Compared to the control subjects, the attributable healthcare cost and LOS were $3159 and 8 days for HIT cases and $18256 and 19 days for HITT cases, respectively. The HITT cases incurred median healthcare costs of $22893 compared with $7799 (p<0.001) for HIT cases without complication. Conclusion: Heparin-induced thrombocytopenia is significantly associated with increased healthcare costs and an increased LOS. These findings suggest that using low-molecular-weight-heparin (LMWH) is one of the strategies aiming to reduce the incidence of HIT.