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Early recognition of pediatric venous thromboembolism: a risk-assessment tool

Andrea S Prentiss1

  • 1Baptist Children's Hospital in Miami, Florida 33176, USA. andreap@baptisthealth.net

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|May 3, 2012
PubMed

Insights

A new tool reliably assesses venous thromboembolism risk in children. Early identification of high-risk pediatric patients, particularly adolescent females, can reduce adverse outcomes from blood clots.

Area of Science:

  • Pediatric Medicine
  • Hematology
  • Medical Device Validation

Background:

  • Venous thromboembolism (VTE) incidence is rising in children, especially those with cancer, surgery, trauma, congenital heart disease, and systemic lupus erythematosus.
  • Early identification of VTE risk factors in pediatric populations is crucial for minimizing morbidity and mortality.
  • Existing assessment methods may lack comprehensive validation for pediatric VTE risk.

Purpose of the Study:

  • To evaluate the reliability and validity of a novel tool designed for assessing venous thromboembolism risk in children.
  • To establish a validated instrument for early risk stratification of pediatric VTE.
  • To provide clinicians with a dependable tool for identifying children at high risk for VTE.

Main Methods:

  • A literature review informed the tool's development, followed by content validity assessment by a multidisciplinary expert team.
  • Retrospective review of 35 patient charts was conducted to establish the tool's reliability and validity.
  • Logistic regression analysis of 1001 patient charts assessed internal consistency, with P < .05 considered statistically significant.

Main Results:

  • The assessment tool demonstrated statistically significant validity across all three risk score categories based on 35 charts.
  • Internal consistency analysis of 1001 patient charts revealed high reliability (χ(2)(5)[n = 1001] = 100.6, P < .001).
  • Patients aged 13–17 years represented the highest-risk group, with females exhibiting over seven times the risk of males for VTE.

Conclusions:

  • The developed assessment tool exhibits strong reliability and validity for identifying pediatric venous thromboembolism risk.
  • A significant correlation was confirmed between the risk score generated by the tool and the actual incidence of VTE.
  • Implementing this validated assessment tool holds the potential to substantially decrease adverse outcomes associated with VTE in children.
Abstract

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