Differentiation of Deep Venous Thrombosis Among Children With or Without Osteomyelitis

Ligon, John A.; Journeycake, Janna M.; Josephs, Shellie C.; Tareen, Naureen; Lindsay, Eduardo A.; Copley, Lawson A.

doi:10.1097/bpo.0000000000001240

Cited by 14 publications

(20 citation statements)

References 18 publications

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“…As a fatal disease caused by serious musculoskeletal infection, VTE needs to arouse the attention of clinical staff. It has been reported that children with OM may have increased susceptibility to VTE in previous epidemiologic studies [ 3 – 5 ]. Unfortunately, the transcriptional signatures between VTE and OM have not been intensively investigated.…”

Section: Discussionmentioning

confidence: 99%

“…This complication should always be considered in patients who present with a musculoskeletal infection, especially osteomyelitis (OM) in younger ones [ 1 , 2 ]. In recent years, the prevalence of DVT among acute haematogenous osteomyelitis (AHO) cases has been reported to be 6–10% [ 3 , 4 ]. In Taiwan, the risk of developing DVT was 2.49-fold in patients with chronic OM compared with the comparison cohort [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have evaluated the clinical characteristics of OM among children with and without DVT [ 3 , 4 ]. Staphylococcus aureus ( S. aureus ) is the predominant causative agent for OM [ 6 ], and clinical outcomes were worse in patients caused by methicillin-resistant S. aureus (MRSA) than in those affected by methicillin-susceptible S. aureus (MSSA) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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The Underlying Molecular Basis and Mechanisms of Venous Thrombosis in Patients with Osteomyelitis: A Data-Driven Analysis

et al. 2022

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Objective. Osteomyelitis (OM) is one of the most risky and challenging diseases. Emerging evidence indicates OM is a risk factor for increasing incidence of venous thromboembolism (VTE) development. However, the mechanisms have not been intensively investigated. Methods. The OM-related dataset GSE30119 and VTE-related datasets GSE19151 and GSE48000 were downloaded from the Gene Expression Omnibus (GEO) database and analyzed to identify the differentially expressed genes (DEGs) (OMGs1 and VTEGs1, respectively). Functional enrichment analyses of Gene Ontology (GO) terms were performed. VTEGs2 and OMGs2 sharing the common GO biological process (GO-BP) ontology between OMGs1 and VTEGs1 were detected. The TRRUST database was used to identify the upstream transcription factors (TFs) that regulate VTEGs2 and OMGs2. The protein-protein interaction (PPI) network between VTEGs2 and OMGs2 was constructed using the Search Tool for the Retrieval of Interacting Genes (STRING) database and then visualized in Cytoscape. Topological properties of the PPI network were calculated by NetworkAnalyzer. The Molecular Complex Detection (MCODE) plugin was utilized to perform module analysis and choose the hub modules of the PPI network. Results. A total of 587 OMGs1 and 382 VTEGs1 were identified from the related dataset, respectively. GO-BP terms of OMGs1 and shared DGEs1 were mainly enriched in the neutrophil-related immune response process, and the shared GO-BP terms of OMGs1 and VTEGs1 seemed to be focused on cell activation, immune, defense, and inflammatory response to stress or biotic stimulus. 230 VTEGs2, 333 OMGs2, and 13 shared DEGs2 were detected. 3 TF-target gene pairs (SP1-LSP1, SPI1-FCGR1A, and STAT1-FCGR1A) were identified. The PPI network contained 1611 interactions among 467 nodes. The top 10 hub proteins were TP53, IL4, MPO, ELANE, FOS, CD86, HP, SOCS3, ICAM1, and SNRPG. Several core nodes (such as MPO, ELANE, and CAMP) were essential components of the neutrophil extracellular traps (NETs) network. Conclusion. This is the first data-mining study to explore shared signatures between OM and VTE by the integrated bioinformatic approach, which can help uncover potential biomarkers and therapeutic targets of OM-related VTE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Underlying Molecular Basis and Mechanisms of Venous Thrombosis in Patients with Osteomyelitis: A Data-Driven Analysis

et al. 2022

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“…Children with osteomyelitis are at increased risk for developing DVTs and differ from those without DVT by higher severity of illness. 14,15 In pediatric patients, the presence of AHO, persistent bacteremia, especially with methicillin-resistant Staphylococcus aureus and respiratory findings are very suggestive of DVT. Screening for DVT in these patients is highly recommended, even in the absence of classic findings of DVTs.…”

Section: Discussionmentioning

confidence: 99%

Inferior Vena Cava Filter in Childhood Septic Deep Vein Thrombosis

Aljabari

Waheed

Davis

et al. 2020

J Pediatr Intensive Care

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Inferior vena cava (IVC) filter in venous thromboembolism (VTE) is an alternative to anticoagulation when the latter is contraindicated. The use of IVC filter in pediatrics continues to be rare and has not increased despite the ever-increasing rates of childhood VTE. Historically, septic VTE was regarded as a contraindication to IVC filter. Safety and efficacy of IVC filters in septic VTE have been reported in adult patients but not in pediatric patients. In this study, we reported a safe use of IVC filter in a critically ill 12-year-old patient with a large IVC thrombus and multiple pulmonary embolisms with favorable outcome.

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“…Another specific pediatric orthopaedic population at increased risk of VTE is children with musculoskeletal infections such as osteomyelitis or septic arthritis, especially if the infecting organism is Staphylococcus aureus 9,19-23 . The severity and duration of elevation in C-reactive protein (CRP) may predict the development of VTE, with every 20 mg/L increase in peak CRP associated with a 29% increase in risk of thrombosis 24 .…”

Section: - Are the Risk Factors For Vte Following Orthopaedic Procedu...mentioning

confidence: 99%

Recommendations from the ICM-VTE: Pediatric

2022

Journal of Bone and Joint Surgery

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The ICM-VTE Pediatric Delegates* 1 -Are the risk factors for VTE following orthopaedic procedures different between children and adults?Response/Recommendation: Many risk factors for venous thromboembolism (VTE) in pediatric orthopaedic patients are similar to those in adults. These include older age (adolescents), trauma, malignancy, certain infections, clotting disorders and a personal or family history of VTE. However, certain VTE risk factors reported in adult literature (e.g., smoking) may be less prevalent in children, and vice versa (e.g., congenital thrombophilia).Strength of Recommendation: Moderate.Delegates vote: Agree 100.00% Disagree 0.00% Abstain 0.00% (Unanimous Strong Consensus).Rationale: VTE is a common complication in adults undergoing orthopaedic surgery, and the risk factors for this condition are well established. In contrast, VTE is extremely rare in pediatric orthopaedic patients 1 . The incidence of VTE has been reported at 0.0515% for pediatric patients admitted following elective orthopaedic procedures 2 . The incidence rises to 0.10% when non-elective procedures are included 3 , and peaks at 0.68% in trauma patients 4,5 .Epidemiologic data has demonstrated that the incidence of pediatric VTE is bimodal, with the highest incidence rates in infants and adolescents 6 . Pediatric patient populations with certain conditions are at an increased risk for VTE. These conditions include: congenital heart disease, nephrotic syndrome, prior splenectomy in patients with hemolytic anemia, colectomy in patients with inflammatory bowel disease, congenital thrombophilia and other genetic or metabolic diseases 7 . Catheter-related thrombosis is the single most common cause of pediatric VTE [8][9][10] . Central venous catheters (CVC) may directly damage the vessel wall, increase blood flow turbulence, introduce substances that damage endothelial cells, and contain thrombogenic materials.Due to the complex pathophysiology of pediatric patients, pediatric orthopaedic patients have different risk factors for VTE compared to their non-orthopaedic counterparts 11,12 . Currently, literature suggests that the most common risk factors for VTE in pediatric orthopaedic patients are adolescent age, trauma, infection, cancer, clotting disorders, and a personal or family history of VTE 9,11,13 .Pediatric trauma patients are an identifiable subgroup that is at highest risk of VTE 14 . However, the risk of VTE is not uniform across age groups, with most cases occurring in children aged 10 -15 years (0.1%). In one study, Guzman et al. 4 , found that younger pediatric trauma patients (i.e., under 10 years) had a much lower risk of VTE compared to adolescents aged 13 -15. Moreover, older adolescent patients (> 16 years) physiologically resembled adults, and had similar VTE frequencies to the adult population 4,8,11,[15][16][17][18] .Another specific pediatric orthopaedic population at increased risk of VTE is children with musculoskeletal infections such as osteomyelitis or septic arthritis, especially if the infectin...

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Differentiation of Deep Venous Thrombosis Among Children With or Without Osteomyelitis

Abstract: Level II-prognostic, retrospective cohort comparison.

Cited by 14 publications

References 18 publications

The Underlying Molecular Basis and Mechanisms of Venous Thrombosis in Patients with Osteomyelitis: A Data-Driven Analysis

The Underlying Molecular Basis and Mechanisms of Venous Thrombosis in Patients with Osteomyelitis: A Data-Driven Analysis

Inferior Vena Cava Filter in Childhood Septic Deep Vein Thrombosis

Recommendations from the ICM-VTE: Pediatric

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