Pediatric Thrombotic Events: Incidence, Clinical Risk Factors and Outcome
Tanay Gupta1, C G Delhi Kumar2, R Ramesh Kumar1
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India.
Insights
Pediatric thrombosis is an emerging concern, with central venous catheters and infections as primary causes. While many children experience resolution, thrombosis contributes to mortality and morbidity in tertiary care settings.
Area of Science:
- Pediatric Medicine
- Hematology
- Critical Care
Background:
- Thrombosis in children is a significant clinical challenge.
- Understanding the incidence and risk factors for pediatric thrombosis is crucial for improving outcomes.
Purpose of the Study:
- To investigate the incidence, clinical risk factors, and outcomes of thrombotic events in children aged 1 month to 12 years.
- To identify the leading causes of thrombosis in the pediatric population within a tertiary care setting.
Main Methods:
- A prospective observational study was conducted over two years (September 2015 - October 2017) at a tertiary care institute.
- Forty-nine children aged 1 month to 12 years diagnosed with thrombosis were enrolled.
Main Results:
- Venous thromboembolism (VTE) accounted for 61.2% of cases, and arterial thromboembolism (ATE) for 38.8%.
- Central venous catheters (38.7%) and infections (20.4%) were the predominant causes of thrombosis.
- Complete resolution occurred in 42.8% of cases, partial resolution in 53.2%, and 14.3% of patients died.
Conclusions:
- Thrombosis represents a growing health issue in pediatric tertiary care, contributing to increased mortality and morbidity.
- Central venous catheter use and infections are identified as the primary drivers of thrombosis in this pediatric cohort.
Objective:
To study the incidence, clinical risk factors and outcome of thrombotic events in pediatric age group of 1 mo-12 y.
Methods:
This prospective observational study was conducted in a tertiary care institute from September 2015 through October 2017. Forty nine children with thrombosis from 1 mo-12 y were enrolled.
Results:
Out of 49 cases, 30 (61.2%) were due to venous thromboembolism (VTE) and 19 (38.8%) were of arterial thromboembolism (ATE). The cumulative average annual incidence for VTEs was found to be 38.2 (n = 30) and for ATEs it was found to be 24.2 (n = 19) per 10,000 hospital admissions over 2 y of study period. With total of 19 (38.7%), catheters were the leading cause of thrombosis followed by infection numbering to 10 cases (20.4%). Total 42.8% cases (n = 21) achieved complete resolution. Partial resolution was noted in 53.2% of cases (n = 26) and no resolution in 4% cases (n = 2). Total seven (14.3%) deaths were recorded during the study period.
Conclusions:
The present study showed that thrombosis is an emerging problem in tertiary care setting adding to both mortality and morbidity in children. Central venous catheters followed by infection were the leading cause of thrombosis in this study.
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