ArticleThe Journal of pediatrics2015
Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system.
Article in The Journal of pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- American Society of Hematology/International Society on Thrombosis and Haemostasis 2024 updated guidelines for treatment of venous thromboembolism in pediatric patients.Blood advances · 2025Guideline
- Heparin-based versus bivalirudin-based anticoagulation in pediatric extracorporeal membrane oxygenation: A systematic review.Frontiers in medicine · 2023Pooled it
- American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia.Blood advances · 2018Guideline
- Use of anticoagulants in children: a cross-sectional study at Albert Royer Children Hospital and Cardio-Pediatric Surgery Center of Fann University Hospital in Dakar, Senegal.The Pan African medical journal · 2025Article
- Where have all the platelets gone? HIT, DIC, or something else?Hematology. American Society of Hematology. Education Program · 2023Review
- Heparin-induced thrombocytopenia in newborns: experience at a pediatric hospital and a literature review.Research and practice in thrombosis and haemostasis · 2023Article
- Heparin Induced Thrombocytopenia - Pathophysiology, Diagnosis and Treatment: A Narrative Review.International journal of general medicine · 2023Review
- Thrombosis and severe acute respiratory syndrome coronavirus 2 vaccines: vaccine-induced immune thrombotic thrombocytopenia.Clinical and experimental pediatrics · 2021Article
- Challenges and Opportunities in the Pharmacological Treatment of Acute Venous Thromboembolism in Children.Paediatric drugs · 2020Review
- Platelet Refractoriness in a Pediatric ECMO Patient: A Case Report.The journal of extra-corporeal technology · 2019Article
- Heparin-induced thrombocytopenia.Blood · 2017Review
- Treatment of Venous Thromboembolism in Pediatric Patients.Frontiers in pediatrics · 2017Review
- Immune pathogenesis of heparin-induced thrombocytopenia.Thrombosis and haemostasis · 2016Review
- Renal vascular thrombosis in the newborn.Pediatric nephrology (Berlin, Germany) · 2016Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo characterize heparin-induced thrombocytopenia (HIT) at a single pediatric center including the prevalence and the accuracy of the 4Ts scoring system as a predictor of HIT. STUDY
designIn this retrospective cohort study, we identified 155 consecutive patients <21 years old with sufficient data for 4Ts scoring. The 4Ts scoring system is a validated pretest tool in adults that predicts the likelihood of HIT using clinical features. Hospital-wide exposure to unfractionated and low molecular weight heparin was determined by querying the hospital pharmacy database.
resultsThe majority of patients with suspected HIT (61.2%) were on surgical services. Prediction of HIT risk using initial 4Ts scoring found 3 (2%) had high risk 4Ts scores, 114 (73%) had intermediate risk 4Ts scores, and the remaining 38 (25%) had low risk 4Ts scores. HIT was confirmed in 0/38 patients with low risk 4Ts scores, 2/114 patients with intermediate-risk 4Ts scores, and all 3 patients with high-risk 4Ts scores presented with HIT with thrombosis. Of 12 positive HIT screening tests, results were falsely positive in 66.6% of patients with intermediate risk 4Ts scores and 100% of patients with low risk 4Ts scores. The prevalence of HIT was 0.058% and HIT with thrombosis was 0.046% in pediatric patients on unfractionated heparin.
conclusionsThe prevalence of HIT appears significantly lower in pediatric patients compared with adults. Application of the 4Ts system as a pretest tool may reduce laboratory evaluation for HIT in heparin-exposed children with low risk 4Ts scores, decreasing unnecessary further testing, intervention, and cost.
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