Analysis of Pediatric Thrombotic Patients in Turkey

Abstract

This study analyzes the data of thrombotic children who were followed up in different pediatric referral centers of Turkey, to obtain more general data on the diagnosis, risk factors, management, and outcome of thrombosis in Turkish children. A simple two-page questionnaire was distributed among contact people from each center to standardize data collection. Thirteen pediatric referral centers responded to the invitation and the total number of cases was 271. All children were diagnosed with thromboembolic disease between January 1995 and October 2001. Median age at time of first thrombotic event was 7.0 years. Of the children 4% of the cases were neonates, 12% were infants less than 1 year old, and 17% were adolescents. Thromboembolic event was mostly located in the cerebral vascular system (32%), deep venous system of the limbs, femoral and iliac veins (24%), portal veins (10%), and intracardiac region (9%). Acquired risk factors were present in 86% of the children. Infection was the most common underlying risk factor. Inherited risk factors were present in 30% of the children. FVL was the most common inherited risk factor. Acquired and inherited risk factors were present simultaneously in 19% of the patients. Eleven children had a history of familial thrombosis. Due to the local treatment preferences, the treatment of the children varied greatly. Outcome of the 142 patients (52%) was reported: 88 (62%) patients had complete resolution, 47 (33%) had complications, 12 (9%) had recurrent thrombosis, and 34 (24%) died. Three children (2.1%) died as a direct consequence of their thromboembolic disease. The significant morbidity and mortality found in this study supports the need for multicentric prospective clinical trials to obtain more generalizable data on management and outcome of thrombosis in Turkish children.

INCIDENCE OF AND RISK FACTORS FOR CHILDHOOD THROMBOSIS: A Single-Center Experience in Ankara, Turkey

“…To our knowledge, there is only 1 report on the risk factors of thrombosis in Turkish children [7]. However, in this multicenter study that summarized the data of the Society of Turkish Pediatric Hematology, the incidence of childhood thrombosis in Turkey has not been evaluated [7].That study, which consisted of 271 patients, revealed that 4% of the patients with thrombosis were neonates, 12% were infants younger than 1 year, and 17% were adolescents. The authors reported that the median age at the time of the first thrombotic event was 7.0 years (range, 1 day to 38 years).…”

“…The incidence of childhood thrombosis has not been established, although venous thrombosis is the type most common in children [4][5][6][7][8][9]. Arterial thrombosis accounts for 26% of all thrombosis that occurs in children [29].…”

“…Thrombosis is a rare multifactorial disorder in childhood, and infants and adolescents are at greater risk. However, in previous studies, the number of pediatric subjects with thrombosis was usually less than 150, and in only a few studies, which were performed in Canada and Europe, were there more than 250 pediatric patients [4][5][6][7][8][9][10].…”

Trombozla başvuran pediatrik hastaların risk faktörleri açısından retrospektif olarak değerlendirilmesi: tek merkez deneyimi

“…Regarding the median age at the time of thrombosis diagnosis in children, Celkan et al reported a median age of 10 years, while Oren et al found this as 7 years, Tavil et al as 10.5 years 10,11,15 . The median age 288 of patients in our study was 5.1 years, which was significantly lower than the findings of other studies.…”

“…Arterial thrombosis was reported to account for 26% of all pediatric thrombosis cases 22 . Although the incidence of arterial thrombosis in children has not been clearly identified in Turkey yet, Oren et al reported an incidence rate of 1.4% 11 .…”