Determination of risk factors for deep venous thrombosis in hospitalized children

Vu, Lan; Nobuhara, Kerilyn K.; Lee, Hanmin; Farmer, Diana L.

doi:10.1016/j.jpedsurg.2008.02.036

Cited by 104 publications

(106 citation statements)

References 15 publications

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“…In a recent restrospective analysis using the Kids' Inpatient Database, independent risk factors for development of DVT in hospitalized children included age 15 years or over, obesity, inflammatory bowel disease, hematologic malignancy, and thoraco-abdominal or orthopedic surgery. 13 By contrast, in a retrospective analysis of the Riley Children's Hospital experience, Sandoval and colleagues observed no consistent trend of increasing VTE risk with age, but rather a bimodal distribution of age with respect to hospital-acquired DVT, with peaks in infancy and adolescence. 14 In one of the only prospective studies of in-hospital DVT, Rohrer and colleagues observed one case of inhospital DVT in 59 at-risk children (defined by the presence of two risk factors, including surgery, trauma, immobility, stroke, cancer, sepsis, femoral venous catheterization, prior VTE, and known thrombophilia), from among 1,779 consecutive hospitalized children over a 6-month period at the University of Massachusetts Medical Center.…”

Section: Discussionmentioning

confidence: 93%

Risk factors for in-hospital venous thromboembolism in children: a case-control study employing diagnostic validation

Branchford¹,

Mourani²,

Bajaj³

et al. 2011

Haematologica

100

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BackgroundStudies evaluating risk factors for in-hospital venous thromboembolism in children are limited by quality assurance of case definition and/or lack of controlled comparison. The objective of this study is to determine risk factors for the development of in-hospital venous thromboembolism in children. Design and MethodsIn a case-control study at The Children's Hospital, Colorado, from 1 st January 2003 to 31 st December 2009 we employed diagnostic validation methods to determine pediatric in-hospital venous thromboembolism risk factors. Clinical data on putative risk factors were retrospectively collected from medical records of children with International Classification of Diseases, 9th edition codes of venous thromboembolism at discharge, in whom radiological reports confirmed venous thromboembolism and no signs/symptoms of venous thromboembolism were noted on admission. ResultsWe verified 78 cases of in-hospital venous thromboembolism, yielding an average incidence of 5 per 10,000 hospitalized children per year. Logistical regression analyses revealed that mechanical ventilation, systemic infection, and hospitalization duration of five days or over were statistically significant, independent risk factors for in-hospital venous thromboembolism (OR=3. ConclusionsThese data indicate that risk of in-hospital venous thromboembolism in children with this risk factor combination may exceed that of hospitalized adults in whom prophylactic anticoagulation is indicated. Substantiation of these findings via multicenter studies could provide the basis for future risk-stratified randomized control trials of pediatric venous thromboembolism prevention.

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Section: Discussionmentioning

confidence: 93%

Risk factors for in-hospital venous thromboembolism in children: a case-control study employing diagnostic validation

Branchford¹,

Mourani²,

Bajaj³

et al. 2011

Haematologica

100

View full text Add to dashboard Cite

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“…These findings are in keeping with other reports in the literature that have identified VTE risk factors. 5,6,9,17,20,22,26,27 In particular, Vu et al 27 performed a cross-sectional study using the 1997, 2000, and 2003 KID to determine the risk factors for VTE in the hospitalized pediatric population. They found older age, thoracoabdominal and orthopedic surgery, obesity, malignancy, inflammatory bowel disease, and longer hospitalization to be independent risk factors for VTE.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism in the setting of pediatric traumatic brain injury

Harris¹,

Lam²

2014

PED

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Object The risk of venous thromboembolism (VTE) in children with traumatic brain injury (TBI) has not been well characterized given its rarity in the pediatric population. Investigation of risk factors for VTE in this group requires the use of a large sample size. Using nationally representative hospital discharge data for 2009, the authors of this study characterize the incidence and risk factors for VTE in children hospitalized for TBI. Methods The authors conducted a cross-sectional study using data from the Healthcare Cost and Utilization Project Kids' Inpatient Database to examine VTE in TBI-associated hospitalizations for patients 20 years of age or younger during the year 2009. Results There were 58,529 children with TBI-related admissions, including 267 with VTE diagnoses. Venous thromboembolisms occurred in 4.6 per 1000 TBI-associated hospitalizations compared with 1.2 per 1000 pediatric hospitalizations overall. By adjusted logistic regression, patients significantly more likely to be diagnosed with VTE had the following: older age of 15–20 years (adjusted odds ratio [aOR] 3.7, 95% CI 1.8–8.0), venous catheterization (aOR 3.0, 95% CI 2.0–4.6), mechanical ventilation (aOR 1.9, 95% CI 1.2–2.9), tracheostomy (aOR 2.3, 95% CI 1.3–4.0), nonaccidental trauma (aOR 2.8, 95% CI 1.1–6.9), increased length of stay (aOR 1.02, 95% CI 1.01–1.03), orthopedic surgery (aOR 2.4, 95% CI 1.8–3.4), and cranial surgery (aOR 1.8, 95% CI 1.1–2.8). Conclusions Using the Kids' Inpatient Database, the authors found that risk factors for VTE in the setting of TBI in the pediatric population include older age, venous catheterization, nonaccidental trauma, increased length of hospital stay, orthopedic surgery, and cranial surgery.

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“…Among pediatric patients, adolescents were reported to have the highest incidence of VTE at 94 cases per 10,000 hospital admissions, and those with a malignancy had the highest rate of first time and subsequent VTE. [11][12][13][14][15] A similar trend has been reported in the adult literature, with a notable increase in the rates of VTE in adults with cancer over the last several decades. 16 Approximately 20% of reported cases of VTE among adults occur in patients with cancer.…”

Section: Epidemiologymentioning

confidence: 53%

Optimal management of venous thromboembolism in adolescent and young adult oncology patients

Brandwein¹,

McKillop²,

Wu³

et al. 2016

COAYA

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Venous thromboembolism (VTE) is a serious complication experienced by adolescents and young adults (AYAs) diagnosed with cancer. Data exist in the adult literature to guide the management of cancer-associated thrombosis. Unfortunately, little is known regarding the epidemiology of cancer-associated thrombosis in AYAs. As a result, evidence on the treatment and prevention of thrombosis in this vulnerable population is lacking, posing a great challenge to physicians caring for AYAs with cancer. It is clear that the basic principles of VTE likely apply to AYAs and that low-molecular-weight heparin is the drug of choice for the treatment of VTE regardless of age. We review the available data on the epidemiology, diagnostic methods, and management of AYAs with cancer and VTE. Recognizing the lack of accepted guidelines for the prevention or management of VTE in this population, we offer expert opinion recommendations to serve as guidance to improve management of thrombosis in AYA cancer patients.

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Determination of risk factors for deep venous thrombosis in hospitalized children

Cited by 104 publications

References 15 publications

Risk factors for in-hospital venous thromboembolism in children: a case-control study employing diagnostic validation

Risk factors for in-hospital venous thromboembolism in children: a case-control study employing diagnostic validation

Venous thromboembolism in the setting of pediatric traumatic brain injury

Optimal management of venous thromboembolism in adolescent and young adult oncology patients

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