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Impact of Platelet Functional Assays on the Cost of Treating Suspected Heparin-Induced Thrombocytopenia.
[heparin-induced thrombocytopenia]
Objectives
:
To
investigate
the
potential
cost
savings
of
using
functional
platelet
assays
to
confirm
the
diagnosis
of
heparin-induced
thrombocytopenia
(
HIT
)
.
Methods
:
This
was
a
single
-center
study
conducted
in
the
United
States
.
We
performed
a
retrospective
cost
of
illness
analysis
of
suspected
HIT
,
comparing
patients
with
the
serotonin
release
assay
(
SRA
)
ordered
as
part
of
their
diagnostic
evaluation
to
those
who
did
not
.
The
primary
clinical
end
point
was
a
composite
of
mortality
and
major
bleed
.
Results
:
A
total
of
147
patients
met
the
study
's
inclusion
criteria
.
An
SRA
was
ordered
in
53
patients
of
whom
17
%
were
positive
.
Overall
,
SRA
use
did
not
reduce
the
composite
primary
clinical
end
point
(
32
.
1
%
vs
33
%
,
P
=
.
911
)
.
Also
,
there
was
no
difference
in
the
total
cost
of
hospital
stay
(
US
$
84781
.
1
vs
US
$
78534
.
4
,
P
=
.
409
)
nor
in
the
direct
medical
costs
related
to
HIT
management
(
US
$
7473
.
5
vs
US
$
8402
.
4
,
P
=
.
393
)
.
Early
ordering
of
the
SRA
(
within
48
hours
)
was
associated
with
shorter
length
of
stay
(
20
vs
27
days
,
P
=
.
029
)
but
without
a
difference
in
cost
of
treatment
.
Conclusion
:
The
use
of
SRA
did
not
reduce
the
costs
or
improve
clinical
outcomes
in
patients
with
suspected
HIT
.
Diseases
Validation
Diseases presenting
"functional platelet assays"
symptom
heparin-induced thrombocytopenia
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