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Published on: February 10, 2023

Venous thromboembolic events in pediatric trauma patients: is prophylaxis necessary?

Michelle C Azu1, Jane E McCormack, Richard J Scriven

  • 1Department of Surgery, Stony Brook University Hospital, Stony Brook, New York 11974, USA.

The Journal of Trauma
|January 6, 2006
PubMed

Insights

Pediatric trauma patients under 13 years old have a negligible risk of venous thromboembolic events (VTE). Prophylaxis for VTE is not necessary in this young trauma population, simplifying care protocols.

Area of Science:

  • Trauma Care
  • Pediatric Critical Care
  • Vascular Medicine

Background:

  • Venous thromboembolic events (VTE) are significant complications in adult trauma patients.
  • Current VTE prophylaxis strategies are established for adults but not well-defined for pediatric trauma.
  • The necessity of VTE prophylaxis in pediatric trauma patients remains an open question.

Purpose of the Study:

  • To evaluate the incidence of VTE in pediatric trauma patients.
  • To determine if VTE prophylaxis is required in the pediatric trauma population.
  • To compare VTE risk across different age groups within a trauma setting.

Main Methods:

  • Retrospective analysis of a Level I trauma center registry (1994-2003).
  • Patients categorized into three age groups: <13 years (Group I), 13-17 years (Group II), and >17 years (Group III).
  • Group I received no VTE prophylaxis; Group III received standard prophylaxis; Group II prophylaxis was surgeon-dependent. Injury Severity Score (ISS) was recorded.

Main Results:

  • A total of 13,880 patients were analyzed.
  • No VTE occurred in the pediatric group (<13 years).
  • Two VTE cases in adolescents (13-17 years) occurred in patients with ISS >24 and contraindications to prophylaxis; 59 VTEs occurred in adults (>17 years).

Conclusions:

  • Clinically significant thromboembolic events are negligible in trauma patients under 13.
  • VTE prophylaxis is not indicated for pediatric patients sustaining traumatic injuries.
  • This finding supports a targeted approach to VTE prevention in pediatric trauma.
Abstract

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