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Clinical features and outcome of pulmonary embolism in children

Tina T Biss1, Leonardo R Brandão, Walter H Kahr

  • 1Department of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.

British Journal of Haematology
|June 20, 2008
PubMed

Insights

Childhood pulmonary embolism (PE) is under-recognized, with immobility and central lines as common risk factors. Despite treatment, significant morbidity and mortality persist, highlighting the need for further research.

Area of Science:

  • Pediatric Medicine
  • Cardiology
  • Hematology

Background:

  • Pulmonary embolism (PE) is uncommon in children but frequently underdiagnosed.
  • Understanding childhood PE requires examining its unique risk factors and outcomes.

Purpose of the Study:

  • To retrospectively review cases of pediatric pulmonary embolism (PE) at a tertiary center.
  • To identify risk factors, diagnostic findings, treatment complications, and outcomes in children with PE.

Main Methods:

  • Retrospective review of 56 children diagnosed with radiologically proven PE over 8 years.
  • Analysis of patient demographics, symptoms, risk factors, thrombophilia, concurrent deep vein thrombosis (DVT), and treatment modalities.
  • Evaluation of therapeutic complications, recurrence rates, and mortality.

Main Results:

  • Most pediatric PE patients (84%) presented with symptoms; 96.4% had risk factors like immobility and central venous lines.
  • Deep vein thrombosis (DVT) was present in 55.4% of cases. Elevated D-dimer was observed in 86.7%.
  • Treatment complications included major hemorrhage (21.4%). Mortality was 21.4%, with 8.9% due to PE and 5.9% due to hemorrhage.

Conclusions:

  • Childhood PE has distinct risk factors compared to adults, and carries significant morbidity and mortality.
  • Current treatment strategies result in complications and persistent mortality.
  • Multicenter prospective studies are essential to establish optimal treatment protocols and long-term outcomes for pediatric PE.

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