Venous Thromboembolic Events in Pediatric Trauma Patients: Is Prophylaxis Necessary?

Abstract

The risk of clinically significant thromboembolic event in trauma patients under age 13 is negligible. Therefore, VTE prophylaxis is unnecessary in pediatric patients with traumatic injury.

Determination of risk factors for deep venous thrombosis in hospitalized children

“…Increasing age has been documented as the most consistent risk factor for thromboembolic events [1,[4][5][6][7]. We excluded neonates and infants in our analysis to focus on DVT of the lower extremities secondary to other causes besides indwelling venous catheters.…”

“…The incidence is lower in children; adults have at least a 7-fold increase relative risk for DVT compared to children [3]. In addition, most children with DVT have underlying disorders and predisposing factors, such as indwelling venous catheters, surgery, trauma, thrombotic disorders, or malignancy [4][5][6][7][8][9]. Our current knowledge about DVT in children is confined to a few reviews of single institution experience or multicenter registries.…”

Increased use of enoxaparin in pediatric trauma patients

“…Since the mid 1990s, several registries and retrospective reviews have reported the rates of venous thromboembolism (VTE) in pediatric trauma patients from 0.7 to 4.2 per 1000 admissions [1][2][3][4][5][6][7]. Venous thromboembolism complications have been shown to independently increase inpatient costs and length of stay in young trauma patients [8].…”

Perioperative Thromboseprophylaxe bei Kindern

“…Es steht außer Diskussion, dass Kinder vor VTE relativ geschützt sind [7,12,20]. Auch beim Vorliegen einer familiären Thrombophilie, werden VTE typischerweise erst im Erwachsenenalter beobachtet [21,22].…”

“…VTE Rönnen zu einer lebensbedrohlichen Pulmonalembolie und einem postthrombotischen Syndrom (PTS) führen [4,5]. VTE sind im Vergleich zu erwachsenen Patienten selten, werden aber in den letzten Jahren immer häufiger diagnostiziert [6,7]. Ursache dafür können verbesserte Überlebenschancen für Kinder mit schweren zugrunde liegenden Erkrankungen und verbesserte und leichter verfügbare Diagnoseverfahren sein.…”