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Venous thromboembolism following inpatient pediatric surgery: Analysis of 153,220 patients

Brandon A Sherrod1, Samuel G McClugage1, Vincent E Mortellaro2

  • 1Department of Neurosurgery, Division of Pediatric Neurosurgery, The University of Alabama at Birmingham and Children's Hospital of Alabama, Birmingham, AL.

Journal of Pediatric Surgery
|October 27, 2018
PubMed

Insights

Pediatric patients undergoing surgery have a 0.20% risk of venous thromboembolism (VTE), with higher rates in cardiothoracic and general surgery. Unique risk factors identified can help predict and prevent VTE in this population.

Area of Science:

  • Pediatric Surgery
  • Vascular Surgery
  • Epidemiology

Background:

  • Venous thromboembolism (VTE) is a significant concern in adult surgical patients.
  • Understanding VTE incidence and risk factors in pediatric surgical populations is crucial for targeted prevention strategies.

Purpose of the Study:

  • To evaluate the incidence of VTE in patients undergoing inpatient pediatric surgery.
  • To identify demographic and perioperative risk factors associated with VTE development post-pediatric surgery.

Main Methods:

  • Analysis of 153,220 inpatient pediatric surgical cases from the 2012-2015 NSQIP-P database.
  • VTE occurrence within 30 days of surgery was the primary outcome.
  • Logistic regression and Kaplan-Meier survival analysis were used to generate prediction models and assess outcomes.

Main Results:

  • A total of 305 patients (0.20%) developed VTE, with a median time to event of 9 days.
  • Cardiothoracic (0.72%) and general surgery (0.28%) subspecialties showed the highest VTE rates.
  • Independent predictors of VTE included higher American Society of Anesthesiologists (ASA) class, preoperative sepsis, ventilator dependence, enteral/parenteral feeding, steroid use, blood transfusion, gastrointestinal disease, hematologic disorders, operative time, and age.

Conclusions:

  • Pediatric postsurgical patients exhibit distinct risk factors for VTE.
  • Identifying these unique risk factors is essential for developing effective VTE prevention protocols in pediatric surgical care.
Abstract

Keywords:
MortalityNSQIPPostoperativeRisk factorsThrombosisVTE

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