Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

Area of Science:

• Pediatric Medicine
• Cardiology
• Pulmonology

Background:

• Pulmonary embolism (PE) in children is associated with significant morbidity and mortality.
• Previous studies identified risk factors for PE in pediatric populations.
• This research aimed to identify novel predictive factors for PE in children.

Purpose of the Study:

• To identify clinical factors associated with an increased probability of diagnosing pulmonary embolism (PE) in children.
• To analyze predictor variables in a combined dataset of pediatric patients tested for PE.

Main Methods:

• Combined data from two retrospective cohorts of patients up to age 21 were analyzed.
• Patients underwent imaging or D-dimer testing for PE, with positive imaging confirming diagnosis.
• Univariate and multivariable logistic regression analyses were performed on 42 predictor variables.

Main Results:

• The study included 1103 patients, with 93 (8.4%) diagnosed with PE.
• Multivariable analysis identified 9 significant predictors of PE: age-adjusted tachycardia, tachypnea, hypoxia, unilateral limb swelling, recent trauma/surgery, prior thromboembolism, cancer, anemia, and leukocytosis.

Conclusions:

• Hypoxia, unilateral limb swelling, recent hospitalization for trauma/surgery, prior thromboembolism, and cancer are key factors in diagnosing pediatric PE.
• Age-adjusted tachycardia, tachypnea, anemia, and leukocytosis also increase PE probability.
• Further prospective studies are needed to validate criteria for initiating PE diagnostic testing in children.