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Risk of venous thromboembolism in children after general surgery

David J Humes1, Agneta Nordenskjöld2, Alex J Walker3

  • 1Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building 2, City Hospital, Nottingham, UK, NG5 1 PB; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden.

Journal of Pediatric Surgery
|June 17, 2015
PubMed

Insights

Children undergoing general surgery have a higher risk of venous thromboembolism (VTE) compared to the general population. However, the absolute risk remains small, necessitating a careful balance in considering thromboprophylaxis.

Area of Science:

  • Pediatric Surgery
  • Thrombosis Research
  • Public Health

Background:

  • Venous thromboembolism (VTE) is a significant concern in surgical patients.
  • Understanding VTE risk in pediatric surgical populations is crucial for effective management.
  • Previous research has not comprehensively compared VTE rates in children undergoing general surgery to the general population.

Purpose of the Study:

  • To determine and compare the absolute and relative rates of VTE in children following general surgical procedures versus the general population.
  • To quantify the risk of VTE in pediatric surgical patients.

Main Methods:

  • Analysis of a large cohort of pediatric patients (<18 years) undergoing general surgery using linked electronic health records (Clinical Practice Research Datalink and Hospital Episode Statistics, England, 2001-2011).
  • Inclusion of a matched general population control group.
  • Calculation of crude VTE rates and adjusted hazard ratios using Cox regression analysis.

Main Results:

  • A total of 15,637 children undergoing surgery and 161,594 population controls were analyzed.
  • Six VTE events occurred in the pediatric surgical cohort within one year post-surgery, compared to five in the control group.
  • The VTE rate following surgery was 0.4 per 1000 person-years, a nine-fold increase in risk (adjusted HR 8.80) compared to the general population (0.04 per 1000 person-years).

Conclusions:

  • Children undergoing general surgical procedures face an elevated risk of VTE compared to the general population.
  • Despite the increased relative risk, the absolute risk of VTE in this pediatric group is low.
  • The decision to use thromboprophylaxis in children post-general surgery should carefully weigh the benefits against potential complications.
Abstract

Keywords:
Deep vein thrombosisGeneral surgeryPulmonary embolus

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