Age, gender, and ethnicity are associated with higher all-cause mortality in hospitalized patients with heparin-induced thrombocytopenia: A nationwide analysis

Abstract Introduction Heparin-induced thrombocytopenia (HIT) is a life-threatening immunologic reaction to heparin exposure that is associated with substantial morbidity and mortality. Limited research is available on host-dependent risk factors, such as age, gender, and ethnicity. This study aims to characterize any association between age, gender, ethnicity, and mortality in HIT patients to better identify patient populations at increased risk. Methods This is a retrospective case control analysis of all-cause mortality in 72,935 patients with a diagnosis of HIT between 2016–2020. Adult patients with HIT were selected using the ICD-10 code D75.82 (HIT) for inclusion and evaluated by demographic, clinical, and hospital characteristics. Odds ratios were calculated for continuous variables using 95% confidence intervals. Multivariable logistic regression was used to ascertain the odds of binary clinical outcomes relative to patient and hospital characteristics as well as the odds of clinical outcomes over time. Results Our analysis indicates that hospitalized patients with HIT are at 5 times higher odds of mortality than in those without HIT (OR: 5.42, 95% CI: 5.15–5.71, p < 0.001). Our data also indicates significantly higher odds of HIT-associated mortality based on patient age, gender, and ethnicity. By age, HIT patients at the highest risk of mortality were found to be between ages 46–60 (Odds Ratio (OR): 2.60, 95% CI: 1.58–4.25), p < 0.001). By gender, females with HIT are at significantly lower odds of mortality compared to males (OR: 0.90, 95% CI: 0.82–0.99, p < 0.001). By ethnicity, Hispanic patients are at the highest risk of mortality (OR: 1.52, 95% CI: 1.31–1.77, p < 0.001), followed by black patients (OR: 1.45, 95% CI: 1.27–1.66, p < 0.001), and then Asian patients (OR: 1.31, 95% CI: 1.00-1.72, p = 0.05). Conclusion HIT remains a clinical diagnosis based on quantitative criteria such as thrombocytopenia relative to baseline and timing of platelet decline but does not take into consideration other clinical variables that may stratify patients by increased risk. This study elucidates the relationship between host-dependent risk factors such as age, gender, and ethnicity, on the risk of all-cause mortality associated with HIT.