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Abstract
Background: Heparin-induced thrombocytopenia (HIT) is an immune-mediated, prothrombotic complication of heparin therapy characterized by a paradoxical decrease in platelet count and an increased risk of thrombosis. Objective: To determine the frequency of heparin-induced thrombocytopenia among critically ill patients receiving unfractionated heparin at a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in the Pathology Department, Surgical ICU, Coronary Care Unit (CCU), and Nephrology Department of Mayo Hospital, Lahore, in collaboration with King Edward Medical University from January 2025 to June 2025. A total of 75 patients of all age groups and both genders receiving unfractionated heparin for 5 to 10 days were included through non-probability consecutive sampling. Patients were evaluated for a fall in platelet count and scored according to the 4Ts scoring system. Results: Among 75 critically ill patients, the mean age was 54.3 ± 13.2 years, and most participants (50.7%) were aged 41–60 years. Males represented 57.3% of the cohort, while females comprised 42.7%. The average duration of heparin therapy was 7.2 ± 2.1 days, and 22.7% of patients had prior heparin exposure within the previous three months. The mean baseline platelet count was 262,000 ± 67,000/mm³, which decreased to 115,000 ± 54,000/mm³ after heparin administration. Heparin-induced thrombocytopenia (HIT) occurred in 11 patients (14.7%), while 64 patients (85.3%) showed no evidence of HIT. HIT was slightly more frequent in males and in those aged 41–60 years, but these differences were not statistically significant. Conclusion: It is concluded that heparin-induced thrombocytopenia occurs with considerable frequency among critically ill patients receiving unfractionated heparin. Regular platelet monitoring, early suspicion through clinical scoring systems, and timely discontinuation of heparin are essential to prevent complications.