title: Impact of Platelet Functional Assays on the Cost of Treating Suspected Heparin-Induced Thrombocytopenia.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  The use of SRA did not reduce the costs or improve clinical outcomes in patients with suspected HIT.
authors.affiliation: Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Ziad G
authors.initials: ZG
authors.lastname: Sadik
authors.affiliation: Department of Pharmacy Practice, Nova Southeastern University, Fort Lauderdale, FL, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Jennings
authors.affiliation: Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Carrie W
authors.initials: CW
authors.lastname: Nemerovski
authors.affiliation: Department of Hematology-Oncology, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Kuriakose
authors.affiliation: Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA jkalus1@hfhs.org.
authors.forename: James S
authors.initials: JS
authors.lastname: Kalus
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D017046:Cost Savings; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006493:Heparin / Q000009:adverse effects*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests / Q000191:economics / Q000379:methods*; D012189:Retrospective Studies; D012701:Serotonin; D013921:Thrombocytopenia / Q000191:economics / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D012701:Serotonin; D006493:Heparin
keywords: cost of illness; direct thrombin inhibitor; heparin; thrombocytopenia; thrombosis