title: The direct medical costs associated with suspected heparin-induced thrombocytopenia.
abstract: BACKGROUND
  Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction associated with heparin exposure. Sunnybrook Health Sciences Centre, a tertiary-care adult academic hospital, has cared for an average of 100 cases of suspected HIT per year. Although the management of suspected HIT is resource intensive, few studies have assessed the cost burden associated with HIT, and none have assessed the costs of suspected HIT.
  
  
  OBJECTIVE
  The objective of this study was to identify and quantify the direct medical costs associated with suspected (confirmed and negative) HIT at a hospital in Canada.
  
  
  METHODS
  A cost-of-illness analysis was conducted in patients with suspected HIT during 2005. Resource utilization variables included (i) laboratory tests to investigate HIT; (ii) HIT-safe anticoagulant use; (iii) diagnostic imaging related to HIT or its treatment; and (iv) additional hospital days attributed to HIT. The average costs per case of confirmed HIT, confirmed HIT with thrombosis (HITT) and negative HIT were calculated in $Can, year 2007 values.
  
  
  RESULTS
  Confirmed HITT cases incurred substantially greater costs ($Can34 155, range 358-202 069; n = 12) than confirmed HIT cases without thrombosis ($Can4575, range 39-16 373; n = 8). The average cost of care for a negative HIT case was $Can119 (range 39-4181; n = 88).
  
  
  CONCLUSIONS
  This is the first study to quantify the costs associated with suspected HIT cases. These cases increase the costs of hospital care and provide further justification for HIT prevention strategies.
authors.affiliation: Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada. natasha.nanwa@utoronto.ca
authors.forename: Natasha
authors.initials: N
authors.lastname: Nanwa
authors.forename: Nicole
authors.initials: N
authors.lastname: Mittmann
authors.forename: Sandra
authors.initials: S
authors.lastname: Knowles
authors.forename: Claudia
authors.initials: C
authors.lastname: Bucci
authors.forename: Rita
authors.initials: R
authors.lastname: Selby
authors.forename: Neil
authors.initials: N
authors.lastname: Shear
authors.forename: Scott E
authors.initials: SE
authors.lastname: Walker
authors.forename: William
authors.initials: W
authors.lastname: Geerts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000191:economics* / Q000628:therapy
chemical_list: D000925:Anticoagulants; D006493:Heparin