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Risk factors for in-hospital venous thromboembolism in children: a case-control study employing diagnostic validation

Brian R Branchford1, Peter Mourani, Lalit Bajaj

  • 1Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation, University of Colorado-Denver and Children's Hospital Colorado, Aurora, CO 80045-0507, USA. brian.branchford@childrens-colorado.org

Haematologica
|December 3, 2011
PubMed

Insights

Mechanical ventilation, systemic infection, and prolonged hospitalization are key risk factors for pediatric in-hospital venous thromboembolism. Identifying these factors can help predict and prevent dangerous blood clots in children.

Area of Science:

  • Pediatric critical care medicine
  • Hematology
  • Clinical epidemiology

Background:

  • Limited data exists on pediatric in-hospital venous thromboembolism risk factors due to case definition quality and lack of controlled studies.
  • Previous research has not adequately identified specific risk factors for pediatric venous thromboembolism (VTE).

Purpose of the Study:

  • To identify and validate risk factors associated with the development of in-hospital venous thromboembolism in children.
  • To establish a reliable method for diagnosing pediatric in-hospital VTE.

Main Methods:

  • A case-control study was conducted at The Children's Hospital, Colorado, between 2003 and 2009.
  • Diagnostic validation methods were used to confirm VTE cases.
  • Retrospective collection of clinical data on potential risk factors from medical records.

Main Results:

  • An incidence of 5 VTE cases per 10,000 hospitalized children annually was observed.
  • Mechanical ventilation, systemic infection, and hospitalization duration of ≥5 days were significant independent risk factors.
  • A risk model incorporating these factors predicted a 3.6% post-test probability of VTE.

Conclusions:

  • The identified risk factor combination suggests a potentially higher VTE risk in children than in hospitalized adults.
  • Further multicenter studies are needed to validate these findings.
  • Results could inform future risk-stratified randomized trials for pediatric VTE prevention.
Abstract

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