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Published on: February 10, 2023

Incidence, risk factors, and treatment patterns for deep venous thrombosis in hospitalized children: an increasing

John A Sandoval1, Michael P Sheehan, Charles E Stonerock

  • 1Department of Surgery, Indiana University School of Medicine and Riley Hospital for Children, Indianapolis, IN 46202, USA.

Journal of Vascular Surgery
|February 26, 2008
PubMed

Insights

The incidence of deep venous thrombosis (DVT) in hospitalized children is rising. Children with severe conditions, central venous catheters, or prior DVT may benefit from prophylaxis.

Area of Science:

  • Pediatric Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Deep venous thrombosis (DVT) management in hospitalized children lacks established guidelines.
  • Pediatric DVT incidence, risk factors, and treatment patterns require further investigation.

Purpose of the Study:

  • To assess the incidence, risk factors, and treatment strategies for DVT in hospitalized pediatric patients.
  • To identify patient subgroups that may benefit from DVT prophylaxis.

Main Methods:

  • Retrospective analysis of pediatric patients (<17 years) with DVT over 14 years.
  • Evaluation of demographic data, clinical factors, Wells clinical probability scores, and treatment patterns.
  • Comparison of treatment trends between 1992-2001 and 2002-2005.

Main Results:

  • DVT incidence increased significantly from 0.3 to 28.8 per 10,000 admissions (1992-2005).
  • Inpatient DVT risk factors included central venous catheters (45%), especially femoral (50%), severe respiratory/oncologic/infectious diseases, and prolonged ICU stays.
  • Prehospital DVT was associated with prior DVT (38%) or thrombophilia (33%).
  • Treatment shifted towards low-molecular-weight heparin.

Conclusions:

  • Hospitalized children, particularly those with severe illnesses, central venous access (femoral), or prior DVT, are candidates for prophylaxis.
  • Clinical probability scores alone are insufficient for risk stratification.
  • Urgent need for childhood-specific trials to establish DVT prophylaxis guidelines.
Abstract

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