Clinical Use of a Scoring System

A practical use of the scoring system is to help make initial clinical decisions regarding therapy. Based on published data, we believe it is likely that a low score (0-3) is associated with a very low risk (<5%) of clinically significant HIT antibodies (defined arbitrarily as >50% serotonin release in a washed platelet activation assay) (Lo et al., 2006) (see Chapter 10). In contrast, a high score (6-8) appears to be associated with a high risk (>80%) of such strong HIT antibodies, at least in some centers. Further, 5075% of patients evaluated for clinical HIT will have low or high scores. This leaves a smaller number of patients in whom the clinical suspicion of HIT is more uncertain (score 4-5) and in whom the results of diagnostic testing will be especially important for supporting (or refuting) the diagnosis of HIT (Warkentin, 2005).

0 0

Post a comment