Risk of venous thromboembolism in people with epilepsy

Martz, Gabriel U.; Wilson, Dulaney A.; Malek, Angela M.; Selassie, Anbesaw W.

doi:10.1111/epi.12796

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…[45,46] Younger and older pediatric patients in a bimodal distribution have the highest VTE risk in the literature relative to the early teen years similar to our findings. [28,47] Ventilator dependence, [48] steroid use, [49] nutritional support, [34] seizure disorders, [50] and preoperative blood transfusions [5] have all been previously reported as VTE risk factors. There were several pertinent negative results within the risk factor analysis.…”

Section: Vte Risk Factorsmentioning

confidence: 99%

Venous thromboembolism following inpatient pediatric surgery: Analysis of 153,220 patients

Sherrod

McClugage

Mortellaro

et al. 2019

Journal of Pediatric Surgery

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Purpose: To evaluate venous thromboembolism (VTE) rates and risk factors following inpatient pediatric surgery.Methods: 153,220 inpatient pediatric surgical patients were selected from the 2012-2015 NSQIP-P database. Demographic and perioperative variables were documented. Primary outcome was VTE requiring treatment within 30 postoperative days. Secondary outcomes included length of stay (LOS) and 30-day mortality. Prediction models were generated using logistic regression. Mortality and time to VTE were assessed using Kaplan-Meier survival analysis.Results: 305 patients (0.20%) developed 296 venous thromboses and 12 pulmonary emboli (3 cooccurrences). Median time to VTE was 9 days. Most VTEs (81%) occurred pre-discharge. Subspecialties with highest VTE rates were cardiothoracic (0.72%) and general surgery (0.28%). No differences were seen for elective vs. urgent/emergent procedures (p=0.106). All-cause mortality VTE patients was 1.2% vs. 0.2% in patients without VTE (p<0.001). After stratifying by American Society of Anesthesiologists (ASA) class, no mortality differences remained when ASA < 3. Preoperative, postoperative, and total LOS were longer for patients with VTE (p<0.001 for each). ASA ≥ 3, preoperative sepsis, ventilator dependence, enteral/parenteral feeding, steroid use, preoperative blood transfusion, gastrointestinal disease, hematologic disorders, operative time, and age were independent predictors (C-statistic=0.83).Conclusions: Pediatric post-surgical patients have unique risk factors for developing VTE.

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Section: Vte Risk Factorsmentioning

confidence: 99%

Venous thromboembolism following inpatient pediatric surgery: Analysis of 153,220 patients

Sherrod

McClugage

Mortellaro

et al. 2019

Journal of Pediatric Surgery

View full text Add to dashboard Cite

show abstract

“…Recently published data showed that patients with epilepsy have an increased risk of thromboembolism [20]. Interestingly, there were no thrombotic events in our cohort, despite the fact that the patients did not receive prophylactic anticoagulation and were relatively immobile during monitoring.…”

Section: Discussionmentioning

confidence: 54%

Safety in the epilepsy monitoring unit: A retrospective study of 524 consecutive admissions

Fahoum

Omer

Kipervasser

et al. 2016

Epilepsy & Behavior

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“…PWE are also at 4-fold increased risk for stroke (5) and face 3-fold increase in the risk for venous thromboembolism (33). More research will be necessary to define factors specific to PWE predisposing to cerebrovascular and cardiovascular disease risk.…”

Section: Key Advances In Area IVmentioning

confidence: 99%

2014 Epilepsy Benchmarks Area IV: Limit or Prevent Adverse Consequence of Seizures and Their Treatment across the Lifespan

et al. 2016

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Epilepsy Resources and Updates Area IV Benchmarks focus on mechanistic understanding and prevention of epilepsy-related consequences. As such, these Benchmarks cover "epilepsy beyond the seizures, " areas related to the neurodevelopment, mental health comorbidities, intellectual functioning, and general health of individuals with epilepsy, the short-and long-term effects of antiseizure treatments, and risks for epilepsy-related mortality. This area also covers unique issues of special populations with seizures, such as pregnant women, children, the elderly, and people with nonepileptic seizures. Key Advances in Area IV Consequences of Epilepsy It is now well established that people with epilepsy (PWE) are affected not only by their disease but that seizures exert much broader consequences on their physical, mental, and social wellbeing. PubMed search using terms "epilepsy and quality of life" and "epilepsy and comorbid conditions" yielded approximately 700 publications between 2013 and 2016. This underscores recent scientific interest in these challenging issues faced by PWE and their families and caregivers. Much work remains to be done to understand risk factors and achieve mechanistic understanding of epilepsy-related comorbidities. Epilepsy and Health-Related Quality of Life (QOL) Epilepsy makes up a quarter of the global disability-adjusted life years for neurologic conditions (1). Systematic survey of 250 epilepsy patients showed that young age, lack of seizure freedom, epilepsy severity, and anxiety are statistically significant predictors of disability, with age and epilepsy severity accounting for 25% and 30% of these determinants, respectively (1). While some concerns seem common to all PWE, there are also syndrome or epilepsy type-specific issues as documented by the recent international collaborative study that analyzed the burden of idiopathic generalized epilepsy (2). Treatment-related adverse effects are also an important determinant of the health-related QOL (3). One must also consider the impact of epilepsy on patients' social network. Parents of children with epilepsy demonstrate diminished health related QOL, and mothers are especially vulnerable to anxiety disorder (4). Epilepsy and Risk of Comorbidities There is growing evidence that the consequences of chronic epilepsy extend beyond the direct effects of seizures. An example is a recent statewide population analysis that included large minority and socioeconomically disadvantaged groups and compared comorbidities in over 64,000 PWE with almost 122,000 patients with migraine (PWM), and nearly 90,000 nonneurological/otherwise healthy controls (5). The absolute risk increase for any somatic and psychiatric/neurodevelopmental comorbidity was 94.3% for PWE compared with 58.8% for PWM (5).

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Risk of venous thromboembolism in people with epilepsy

Cited by 10 publications

References 25 publications

Venous thromboembolism following inpatient pediatric surgery: Analysis of 153,220 patients

Venous thromboembolism following inpatient pediatric surgery: Analysis of 153,220 patients

Safety in the epilepsy monitoring unit: A retrospective study of 524 consecutive admissions

2014 Epilepsy Benchmarks Area IV: Limit or Prevent Adverse Consequence of Seizures and Their Treatment across the Lifespan

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