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HIT Expert Probability (HEP) Score for Heparin-Induced Thrombocytopenia

Type of heparin-induced thrombocytopenia onset suspected
Typical
Rapid
Magnitude of platelet count fall
Peak to nadir count since heparin
<30% -1
30-50% 1
>50% 3
Timing of platelet count fall
Fall begins <4 days after heparin exposure -2
Fall begins 4 days after heparin exposure 2
Fall begins 5-10 days after heparin exposure 3
Fall begins 11-14 days after heparin exposure 2
Fall begins >14 days after heparin exposure -1
Timing of platelet count fall
Fall begins <48 hours after heparin re-exposure 2
Fall begins >48 hours after heparin re-exposure -1
Nadir platelet count
≤20 -2
>20 2
Thrombosis
New venous thromboembolism (VTE) or arterial thromboembolism (ATE) ≥4 days after heparin exposure 3
Progression of pre-existing venous thromboembolism (VTE) or arterial thromboembolism (ATE) while receiving heparin 2
None 0
Thrombosis
New venous thromboembolism (VTE) or arterial thromboembolism (ATE) after heparin exposure 3
Progression of pre-existing venous thromboembolism (VTE) or arterial thromboembolism (ATE) while receiving heparin 2
None 0
Skin necrosis at subcutaneous heparin injection sites
No 0
Yes 3
Acute systemic reaction after IV heparin bolus
No 0
Yes 2
Presence of bleeding, extensive bruising or petechiae
No 0
Yes -1
Presence of chronic thrombocytopenic disorder
No 0
Yes -1
Newly initiated non-heparin medication known to cause thrombocytopenia
No 0
Yes -1
Severe Infection
No 0
Yes -2
Severe disseminated intravascular coagulation
Fibrinogen <100 mg/dL and D-dimer >5 µg/mL
No 0
Yes -2
Indwelling intra-arterial device ECMO, VAD, IABP
No 0
Yes -2
Cardiopulmonary bypass within previous 96 hours
No 0
Yes -1
No other apparent cause
No 0
Yes 3
Result:

Background

Result Interpretation

Ranges Ranges