PROBLEM: A life-threatening complication of the thrombembolism prophylaxis with heparin is @entity882 ( @entity882 ) type II. @entity882 is based on immunological mechanisms. Even low, subcutaneously applied doses may produce @entity882 . In those @entity1 , continued application may cause @entity1031 complications. The most important symptom of @entity882 is a decrease of platelets. METHODS: In a prospective study, we investigated the incidence of @entity882 within the period from 01.07.95 to 30.06.96 in orthopedic @entity1 . We also evaluated the importance of the daily platelet count from the fifth postoperative day for the early diagnosis of @entity882 and a possible reduction of the @entity715 rate. The study included 307 @entity1 after primary implantation of hip and knee endoprosthesis and after hip endoprosthesis replacement. All @entity1 received 3 x 5000 IU/d of unfractionated heparin subcutaneously. Whenever there was a decrease of platelets of at least 50% in relation to the preoperative value or whenever @entity532 occurred, serum was analyzed by the heparin-induced platelet activation test (HIPA). RESULTS: 20 @entity1 developed @entity882 . This corresponds to an incidence of 6.5%. 10 of the @entity882 antibody positive @entity1 (50%) developed @entity532 . 3 @entity1 (0.9%) of the group studied developed clinically symptomatic @entity532 without evidence of heparin antibodies. The total risk of getting @entity532 was 4.2% (13 @entity1 ). 3.3% (10 @entity1 ) of the entire group developed @entity882 antibody associated @entity532 ; 1 @entity1 died. The lethality in the @entity882 antibody positive @entity1 group amounted to 5%. The @entity1 with @entity882 received LMW heparinoid @entity10269 (AKZO-Organon, The Netherlands) or @entity20389 (as a clinical trial). The comparison group (retrospective study from 17.10.92 to 16.10.93) was composed of 262 @entity1 with the same operations and equal @entity1031 prophylaxis. The platelet count was made only as part of routine diagnostic tests. 21 @entity1 (8.0%) developed clinically symptomatic @entity532 . The difference in the @entity715 rate between these two groups of @entity1 is statistically significant. Unrecognized @entity882 is probably the reason for the high thrombembolic complication rate in the comparison group. CONCLUSIONS: The daily platelet count from the fifth postoperative day and from the first day in case of reexposure to heparin is an important measure for the early diagnosis of @entity882 .

[Prevention of XXXX as a cause of @entity1031 complications. A study of the incidence of @entity882 type II].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity882 :: ('MESH:D013921', 'Disease') :: ['HIT type II', 'HIT', 'heparin-induced thrombocytopenia'] @entity20389 :: ('MESH:D006629', 'Chemical') :: ['hirudin'] @entity532 :: ('MESH:D003925', 'Disease') :: ['thrombembolic complications'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolism', 'thromboembolic'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity10269 :: ('MESH:C035838', 'Chemical') :: ['Orgaran']
@entity1031 :: (MESH:D013923,Disease) :: ['thromboembolism']
