| Id |
Subject |
Object |
Predicate |
Lexical cue |
| TextSentencer_T1 |
0-47 |
Sentence |
denotes |
Delayed-onset heparin-induced thrombocytopenia. |
| TextSentencer_T2 |
48-59 |
Sentence |
denotes |
BACKGROUND: |
| TextSentencer_T3 |
60-188 |
Sentence |
denotes |
Heparin-induced thrombocytopenia presents 5 to 12 days after heparin exposure, with or without arterial or venous thromboemboli. |
| TextSentencer_T4 |
189-295 |
Sentence |
denotes |
Delayed recognition and treatment of heparin-induced thrombocytopenia contribute to poor patient outcomes. |
| TextSentencer_T5 |
296-306 |
Sentence |
denotes |
OBJECTIVE: |
| TextSentencer_T6 |
307-450 |
Sentence |
denotes |
To describe and increase awareness of a clinical scenario in which the onset or manifestations of heparin-induced thrombocytopenia are delayed. |
| TextSentencer_T7 |
451-458 |
Sentence |
denotes |
DESIGN: |
| TextSentencer_T8 |
459-485 |
Sentence |
denotes |
Retrospective case series. |
| TextSentencer_T9 |
486-494 |
Sentence |
denotes |
SETTING: |
| TextSentencer_T10 |
495-569 |
Sentence |
denotes |
Three large urban hospitals (with active cardiovascular surgery programs). |
| TextSentencer_T11 |
570-579 |
Sentence |
denotes |
PATIENTS: |
| TextSentencer_T12 |
580-733 |
Sentence |
denotes |
14 patients seen over a 3-year period in whom heparin-induced thrombocytopenia became apparent on delayed presentation with thromboembolic complications. |
| TextSentencer_T13 |
734-747 |
Sentence |
denotes |
MEASUREMENTS: |
| TextSentencer_T14 |
748-888 |
Sentence |
denotes |
Platelet counts, onset of objectively determined thromboembolism, results of heparin-induced platelet factor 4 antibody tests, and outcomes. |
| TextSentencer_T15 |
889-897 |
Sentence |
denotes |
RESULTS: |
| TextSentencer_T16 |
898-1110 |
Sentence |
denotes |
Patients went home after hospitalizations that had included heparin exposure--in most cases, with no thrombocytopenia recognized--only to return to the hospital (median, day 14) with thromboembolic complications. |
| TextSentencer_T17 |
1111-1209 |
Sentence |
denotes |
Thromboemboli were venous (12 patients, 7 with pulmonary emboli) or arterial (4 patients) or both. |
| TextSentencer_T18 |
1210-1293 |
Sentence |
denotes |
Platelet counts were mildly decreased in all but 2 patients on second presentation. |
| TextSentencer_T19 |
1294-1552 |
Sentence |
denotes |
On readmission, 11 patients received therapeutic heparin, which worsened the patients' clinical condition and, in all 11 cases, decreased the platelet count (mean at readmission, 143 x 10(9) cells/L; mean nadir after heparin re-exposure, 39 x 10(9) cells/L). |
| TextSentencer_T20 |
1553-1641 |
Sentence |
denotes |
Results of serologic tests for heparin-induced antibodies were positive in all patients. |
| TextSentencer_T21 |
1642-1828 |
Sentence |
denotes |
Subsequent treatments included alternative anticoagulants (11 patients), thrombolytic drugs (3 patients), inferior vena cava filters (3 patients) and, eventually, warfarin (11 patients). |
| TextSentencer_T22 |
1829-1849 |
Sentence |
denotes |
Three patients died. |
| TextSentencer_T23 |
1850-1862 |
Sentence |
denotes |
CONCLUSIONS: |
| TextSentencer_T24 |
1863-1943 |
Sentence |
denotes |
Delayed-onset heparin-induced thrombocytopenia is increasingly being recognized. |
| TextSentencer_T25 |
1944-2177 |
Sentence |
denotes |
To avoid disastrous outcomes, physicians must consider heparin-induced thrombocytopenia whenever a recently hospitalized patient returns with thromboembolism; therapy with alternative anticoagulants, not heparin, should be initiated. |
| T1 |
0-47 |
Sentence |
denotes |
Delayed-onset heparin-induced thrombocytopenia. |
| T2 |
48-59 |
Sentence |
denotes |
BACKGROUND: |
| T3 |
60-188 |
Sentence |
denotes |
Heparin-induced thrombocytopenia presents 5 to 12 days after heparin exposure, with or without arterial or venous thromboemboli. |
| T4 |
189-295 |
Sentence |
denotes |
Delayed recognition and treatment of heparin-induced thrombocytopenia contribute to poor patient outcomes. |
| T5 |
296-306 |
Sentence |
denotes |
OBJECTIVE: |
| T6 |
307-450 |
Sentence |
denotes |
To describe and increase awareness of a clinical scenario in which the onset or manifestations of heparin-induced thrombocytopenia are delayed. |
| T7 |
451-458 |
Sentence |
denotes |
DESIGN: |
| T8 |
459-485 |
Sentence |
denotes |
Retrospective case series. |
| T9 |
486-494 |
Sentence |
denotes |
SETTING: |
| T10 |
495-569 |
Sentence |
denotes |
Three large urban hospitals (with active cardiovascular surgery programs). |
| T11 |
570-579 |
Sentence |
denotes |
PATIENTS: |
| T12 |
580-733 |
Sentence |
denotes |
14 patients seen over a 3-year period in whom heparin-induced thrombocytopenia became apparent on delayed presentation with thromboembolic complications. |
| T13 |
734-747 |
Sentence |
denotes |
MEASUREMENTS: |
| T14 |
748-888 |
Sentence |
denotes |
Platelet counts, onset of objectively determined thromboembolism, results of heparin-induced platelet factor 4 antibody tests, and outcomes. |
| T15 |
889-897 |
Sentence |
denotes |
RESULTS: |
| T16 |
898-1110 |
Sentence |
denotes |
Patients went home after hospitalizations that had included heparin exposure--in most cases, with no thrombocytopenia recognized--only to return to the hospital (median, day 14) with thromboembolic complications. |
| T17 |
1111-1209 |
Sentence |
denotes |
Thromboemboli were venous (12 patients, 7 with pulmonary emboli) or arterial (4 patients) or both. |
| T18 |
1210-1293 |
Sentence |
denotes |
Platelet counts were mildly decreased in all but 2 patients on second presentation. |
| T19 |
1294-1552 |
Sentence |
denotes |
On readmission, 11 patients received therapeutic heparin, which worsened the patients' clinical condition and, in all 11 cases, decreased the platelet count (mean at readmission, 143 x 10(9) cells/L; mean nadir after heparin re-exposure, 39 x 10(9) cells/L). |
| T20 |
1553-1641 |
Sentence |
denotes |
Results of serologic tests for heparin-induced antibodies were positive in all patients. |
| T21 |
1642-1828 |
Sentence |
denotes |
Subsequent treatments included alternative anticoagulants (11 patients), thrombolytic drugs (3 patients), inferior vena cava filters (3 patients) and, eventually, warfarin (11 patients). |
| T22 |
1829-1849 |
Sentence |
denotes |
Three patients died. |
| T23 |
1850-1862 |
Sentence |
denotes |
CONCLUSIONS: |
| T24 |
1863-1943 |
Sentence |
denotes |
Delayed-onset heparin-induced thrombocytopenia is increasingly being recognized. |
| T25 |
1944-2177 |
Sentence |
denotes |
To avoid disastrous outcomes, physicians must consider heparin-induced thrombocytopenia whenever a recently hospitalized patient returns with thromboembolism; therapy with alternative anticoagulants, not heparin, should be initiated. |