Anti-PF4/heparin antibodies associated with repeated hemofiltration-filter clotting: a retrospective study

Lasocki, Sigismond; Piednoir, Pascale; Ajzenberg, Nadine; Geffroy, Arnaud; Benbara, Abdel; Montravers, Philippe

doi:10.1186/cc6937

Critical Care

Table 1 Characteristics of the study population

From: Anti-PF4/heparin antibodies associated with repeated hemofiltration-filter clotting: a retrospective study

										Time to onset, days				Platelet counts, 10⁹/L			aPTT ratios
	Patient	Gender	Age, years	SAPS II	SOFA score	Type of surgery	Sepsis	Shock	MV	ICU	CVVH	UFH	ICU length of stay, days	D₀	D_PF4	Four T-score	Mean	≥ 1.2, %	CVVH duration, hours	PF4, OD	Death
PF4⁺	1	M	54	34	12	Cardiac	No	Yes	Yes	8	6	8	22	42	10	5	1.2	50	14	1.18	No
	2	M	59	29	6	Cardiac	No	No	No	6	6	9	13	76	51	7	1.2	100	2	2.26	No
	3	M	63	50	13	Cardiac	Yes	Yes	Yes	9	8	9	28	101	20	7	1.3	33	4	2.68	No
	4	F	49	44	11	Cardiac	No	Yes	Yes	7	7	8	8	251	95	7	1.2	33	6	1.89	Yes
	5	M	62	86	16	Trauma	Yes	Yes	Yes	15	13	14	22	163	66	5	2.4	100	5	1.18	Yes
	6	M	55	52	12	Cardiac	No	Yes	Yes	10	8	11	26	144	200	4	1.9	100	2	2.00	No
	7	M	57	42	14	Cardiac	Yes	Yes	Yes	16	15	20	43	78	46	5	2.6	100	8	2.11	No
Total (n = 7)		6 M (86%)	57 (55–62)	44^a (36–51)	12.5 (12–14)	6 cardiac (86%)	3 (43%)	6 (86%)	6 (86%)	9 (8–15)	8 (6–13)	9 (9–14)	22 (18–28)	101 (77–158)	51 (26–88)	5 (5–7)	1.3 (1.2–2.4)	100 (50–100)	5^a (2.5–7.5)	2.00^a (1.36–2.22)	2 (40%)
PF4^-	8	F	78	64	11	Visceral	Yes	Yes	Yes	4	2	5	4	109	48	6	3.1	100	19	0.11	Yes
	9	M	51	51	8	Visceral	Yes	Yes	Yes	5	5	5	16	413	234	6	1.6	75	4	0.19	No
	10	M	58	65	19	Cardiac	Yes	Yes	Yes	3	2	10	26	214	42	6	1.2	67	10	0.40	No
	11	M	77	68	15	Cardiac	Yes	Yes	Yes	14	14	24	47	176	52	5	1.8	100	12	0.13	Yes
	12	M	78	56	16	Cardiac	No	Yes	Yes	4	4	5	15	100	22	5	1.7	100	12	0.26	Yes
	13	M	83	89	18	Cardiac	Yes	Yes	Yes	4	3	5	28	86	33	6	1.8	100	9	0.17	Yes
	14	M	78	59	11	Cardiac	Yes	Yes	Yes	5	2	4	14	141	31	6	1.8	100	10	0.07	Yes
	15	M	37	35	14	Trauma	Yes	Yes	Yes	9	7	7	25	146	63	4	1.1	25	7	0.09	No
	16	F	73	62	15	Cardiac	Yes	Yes	Yes	36	36	39	50	94	48	5	3.9	100	24	0.29	Yes
	17	M	79	59	10	Visceral	Yes	Yes	Yes	9	9	9	12	169	86	6	1.4	100	31	0.18	Yes
	18	M	60	49	10	Cardiac	No	No	Yes	5	3	5	14	60	39	5	1.3	100	24	0.09	No
	19	M	48	48	8	Visceral	Yes	Yes	Yes	6	2	9	27	258	167	6	1.8	100	24	0.08	Yes
	20	F	75	54	11	Visceral	Yes	Yes	Yes	6	4	7	12	86	21	6	1.9	100	4	0.34	Yes
	21	M	60	39	13	Cardiac	No	Yes	Yes	4	3	5	58	61	47	6	1.5	100	24	0.19	No
	22	M	75	56	13	Cardiac	Yes	Yes	Yes	19	17	20	37	105	45	5	1.2	25	8	0.83	Yes
	23	M	78	57	13	Cardiac	Yes	Yes	Yes	5	4	6	61	67	44	6	1.0	0	13	0.02	No
	24	M	64	73	14	Visceral	No	Yes	Yes	16	16	16	26	206	95	6	1.4	100	16	0.24	No
	25	M	38	71	20	Vascular	Yes	Yes	Yes	4	4	4	33	210	49	6	1.7	100	18	0.20	No
	26	M	69	66	13	Cardiac	Yes	Yes	Yes	5	4	5	11	140	48	6	1.1	25	6	0.51	Yes
	27	F	37	52	13	Cardiac	Yes	Yes	Yes	6	5	9	27	57	234	6	1.4	100	7	0.58	No
	28	M	75	44	10	Visceral	Yes	Yes	Yes	22	20	24	53	203	42	5	1.4	86	24	0.29	Yes
Total (n = 21)		17 M(81%)	73 (56–78)	57 (50–65)	13 (10–15)	12 cardiac (57%)	17 (81%)	20 (95%)	21 (100%)	5 (4–9)	4 (3–10)	7 (5–12)	26 (14–39)	140 (86–204)	48 (41–69)	6 (5–6)	1.5 (1.3–1.8)	100 (73–100)	12 (7.5–24)	0.20 (0.10–0.32)	12 (57%)

Patients were classified into two groups (PF4⁺ and PF4^-) according to anti-PF4/heparin antibody concentration (optical density [OD] > 1 IU or not). PF4⁺ patients 1 to 4 also had a positive functional test for heparin-induced thrombocytopenia (platelet-rich plasma aggregation test). No differences between these four patients and the remaining three patients with a negative functional test were observed. The types of surgery for the two trauma patients were orthopedic and visceral for patient 5 and visceral surgery only for patient 15. Shock was defined as the need for vasopressor support. Time to onset is the time between intensive care unit (ICU) admission or continuous veno-venous hemofiltration (CVVH) or unfractionated heparin (UFH) and the day of anti-PF4/heparin antibody assay. The Four T-score was calculated by considering that hemofiltration-filter clotting did constitute a 'recurrent thrombosis' (= 1 point) [9]. Results are expressed as median (first quartile to third quartile) or number. ^aP < 0.05. M, male; F, female; aPTT, activated partial thromboplastin time (observed during the continuous veno-venous hemofiltration session with hemofiltration-filter clotting); D₀, day of admission; D_PF4, day of anti-PF4/heparin antibody assay; MV, mechanical ventilation; PF4^-, anti-PF4/heparin antibody-negative; PF4⁺, anti-PF4/heparin antibody-positive; SAPS II, Simplified Acute Physiologic Score [19]; SOFA, Sepsis-related Organ Failure Assessment [20].

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ISSN: 1364-8535

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