Hospital-Associated Venous Thromboembolism in Children: Incidence and Clinical Characteristics

Takemoto, Clifford M.; Sohi, Sajeet; Desai, Kruti; Bharaj, Raman; Khanna, Anuj; McFarland, Susan; Klaus, Sybil Ann; Irshad, Alia; Goldenberg, Neil A.; Strouse, John J.; Streiff, Michael B.

doi:10.1016/j.jpeds.2013.10.025

Cited by 120 publications

(112 citation statements)

References 26 publications

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“…A single centre retrospective study of hospital associated VTE reported that 18% of patients with an admission for VTE had undergone a general surgical or trauma related surgical procedure in the three months prior to admission with VTE [6]. This is in keeping with our finding of the majority of VTE events occurring post discharge with the highest rates in the first three months following discharge.…”

Section: Other Literaturesupporting

confidence: 86%

“…The also included recurrent VTE events which will have overestimated the occurrence of VTE in hospitalised patients as prior VTE is a known risk factor for subsequent VTE [6]. Interestingly they did report that fifty of their cases had undergone either trauma surgery or general surgery in the three months prior to VTE but did not give rates specific to general surgery.…”

Section: Other Literaturementioning

confidence: 99%

“…Previous studies reporting the occurrence of VTE in the children have concentrated on the overall occurrence during hospitalisation and have not reported how the risk of VTE alters with time following hospitalisation with the majority of studies reporting in-patient data only [5][6][7]24]. A single centre retrospective study of hospital associated VTE reported that 18% of patients with an admission for VTE had undergone a general surgical or trauma related surgical procedure in the three months prior to admission with VTE [6].…”

Section: Other Literaturementioning

confidence: 99%

“…The annual reported incidence of VTE in children has been reported as 0.07-0.14 per 10,000 children or 5-58 per 10,000 hospital pediatric admissions [2][3][4][5][6]. The rates of childhood VTE related hospitalisation have been reported to be increasing although this may reflect increased awareness, better diagnostic tools or increased use of indwelling catheters [5,7].…”

Section: Introductionmentioning

confidence: 99%

“…Known risk factors for VTE in childhood include central venous lines, sepsis, malignancy, surgery, trauma and medical comorbidities [1,[8][9][10][11][12][13]. There are no population-based estimates of the risk of VTE following general surgery in childhood, which is considered to be a risk factor for VTE and is performed on over 40,000 children per year in England and 220,000 in the United States [6,13,14]. As a consequence of the lack of data on the risk of VTE following surgery there is currently a limited evidence base on which to make recommendations for prevention [1,15].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Risk of venous thromboembolism in children after general surgery

Humes

Nordenskjöld

Walker

et al. 2015

Journal of Pediatric Surgery

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Section: Other Literaturesupporting

confidence: 86%

Section: Other Literaturementioning

confidence: 99%

Section: Other Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk of venous thromboembolism in children after general surgery

Humes

Nordenskjöld

Walker

et al. 2015

Journal of Pediatric Surgery

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Deep vein thrombosis in pediatric patients

Jaffray

2017

Pediatric Blood & Cancer

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Due to advances in caring for critically ill children and those with chronic diseases, rates of deep vein thrombosis (DVT) are increasing in children. Risk factors consist of central venous catheters, chronic medical conditions, thrombophilia, and various medications. Compression Doppler ultrasonography is the method most commonly used to diagnose DVT, and patients will usually present with pain and swelling of the affected limb. Anticoagulation via subcutaneous injection is the most common treatment regime for children with DVT, and the new, direct oral anticoagulants are currently under investigation. Prevention techniques are not established, but clinical studies are addressing this need.

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Venous thromboembolism in children with central nervous system tumors: Comparison of an institutional cohort to a national administrative database

Graham

Coven

Stanek

et al. 2020

Pediatric Blood & Cancer

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Background: Central nervous system (CNS) tumors are the second most common malignancy of childhood, and published data on venous thromboembolism (VTE) rate and risk factors for these patients are outdated or incomplete. Here, we determine the cumulative incidence and risk factors for VTE in this population. Procedure: VTE diagnosis and associated clinical risk factors were abstracted and analyzed for two cohorts of children (0-21 years) diagnosed with CNS tumors between January 1, 2010 to September 30, 2018. The first study was a retrospective single institution cohort study. The initial observations were confirmed across multiple pediatric hospitals using the Pediatric Health Information System (PHIS) administrative database. Results: The single-institution cohort included 338 patients aged 3 days to 20.9 years (median age, 8.6 years); VTE developed in eight (2.4%) patients. The PHIS cohort included 17 634 patients aged from 0 to 21.9 years (median: 9.5 years); VTE developed in 354 (2.0%) patients. Univariate analysis for the single-institution cohort identified central venous catheter (CVC) placement as a risk factor for VTE (odds ratio [OR] 8.40, 95% confidence interval [CI] 1.43-49.41, P = .0186). Multivariable analysis of the PHIS dataset identified CVC placement (OR 1.97, 95% CI 1.57-2.46; P < .0001), obesity (OR 2.96, 95% CI 1.21-7.26; P = .0177), and more than one hospital admission (OR 3.54, 95% CI 2.69-4.64; P < .0001) as significant predictors of VTE. VTE diagnosis was not associated with increased mortality in either cohort. Conclusions: The VTE rate in children with CNS tumors is low (2%). CVC placement was identified as a modifiable risk factor in both cohorts.

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Hospital-Associated Venous Thromboembolism in Children: Incidence and Clinical Characteristics

Cited by 120 publications

References 26 publications

Risk of venous thromboembolism in children after general surgery

Risk of venous thromboembolism in children after general surgery

Deep vein thrombosis in pediatric patients

Venous thromboembolism in children with central nervous system tumors: Comparison of an institutional cohort to a national administrative database

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