Pouplard et al developed a score using clinical criteria can help to estimate the likelihood of heparin-induced thrombocytopenia in a patient currently or recently treated with heparin.
Parameters for score:
(1) platelets
(2) presence of thrombosis
(3) findings on heparin rechallenge
(4) status of other causes for thrombocytopenia
|
Parameter |
Finding |
Points |
|
platelets |
• platelet count > 120,000 per µL before heparin, AND platelet count < 100,000 per µL during therapy, OR decrease of at least 40% in platelet count • thrombocytopenia resolving within 10 days after discontinuation of heparin |
+2 |
|
|
platelet count recovered while receiving another kind of heparin |
0 |
|
|
platelet count recovered while receiving the same kind of heparin |
-1 |
|
|
thrombocytopenia not resolving after discontinuation of heparin |
-2 |
|
thrombosis |
arterial thrombosis without predisposing factor |
+4 |
|
|
arterial thrombosis with possible predisposing factor |
+2 |
|
|
venous thrombosis during high-dose heparin therapy |
+2 |
|
|
other thrombosis |
+1 |
|
|
no thrombosis |
0 |
|
rechallenge |
recurrence of thrombocytopenia after re-exposure to heparin |
+6 |
|
|
no recurrence of thrombocytopenia after re-exposure to heparin |
-1 |
|
other causes of thrombocytopenia |
excluded |
+2 |
|
|
another drug possibly responsible |
0 |
|
|
cause other than drug likely (sepsis, etc.) |
-2 |
after Table 1, page 701, Pouplard 1999
score =
= SUM(points for the parameters present)
Interpretation:
• minimum score: -5
• maximum score: 14
|
Score |
Interpretation |
|
>= 6 |
definite heparin-induced thrombocytopenia |
|
3 - 5 |
probable |
|
1 - 2 |
possible |
|
<= 0 |
unlikely |
Purpose: To use a clinical score to determine the likelihood of heparin-induced thrombocytopenia in a patient.
Specialty: Hematology Oncology, Clinical Laboratory, Pharmacology, clinical, Critical Care, Immunology/Rheumatology
Objective: severity, prognosis, stage, complications, adverse effects, complication detection
ICD-10: D69,
