Heparin-Induced Thrombocytopenia Alert Analysis

Abstract

Specific Aims: To evaluate the various parameters for triggering a heparin-induced thrombocytopenia (HIT) alert including platelet count, duration of heparin therapy from start date to when alert triggered, and percent drop in platelet count from baseline, and to review how those affect the positive predictive value. Subjects: Patients across all Banner Health facilities from January 2016 to December 2018 who had a HIT alert triggered during their stay. Methods: Positive predictive value (PPV) was calculated for 84 different logic rule combinations of platelet count, duration of heparin therapy to alert trigger, and percent drop in platelet count from baseline. A chi squared analysis of each individual criterion was then performed in order to select a logic rule that maximized the PPV and minimized the HIT alerts populated. Main Results: Using a logic rule of absolute platelet count of 150,000 or less, percent decrease of 50% or greater, and any duration would provide a PPV of 11.8% and 1,383 less alerts compared to Banner's current logic rule. Conclusions: Changing Banner's logic rule to absolute platelet count of 150,000 or less, percent decrease of 50% or greater, and any duration may be beneficial as it results in fewer total alerts triggered while also increasing the PPV.