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Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events

Elbert Johann Mets1, Ryan Patrick McLynn1,2, Jonathan Newman Grauer1

  • 1Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.

World Journal of Pediatric Surgery
|December 7, 2022
PubMed

Insights

Postoperative venous thromboembolism (VTE) affects 0.10% of pediatric surgical patients. Risk factors include higher American Society of Anesthesiologists class, older age, non-elective procedures, and longer operative times.

Area of Science:

  • Pediatric Surgery
  • Vascular Medicine
  • Patient Safety

Background:

  • Venous thromboembolism (VTE) is a serious, preventable complication in children, though less common than in adults.
  • While VTE in hospitalized and trauma pediatric patients is studied, postoperative VTE in surgical pediatric patients remains underexplored.

Purpose of the Study:

  • To determine the incidence of postoperative VTE in children undergoing surgery.
  • To identify risk factors associated with VTE in pediatric surgical patients.
  • To evaluate the relationship between VTE and other postoperative adverse outcomes.

Main Methods:

  • Retrospective cohort analysis of the National Surgical Quality Improvement Project Pediatric database (NSQIP-P) from 2012 to 2016.
  • Inclusion of 361,384 pediatric surgical patients.
  • Statistical analysis to identify significant risk factors and outcome associations.

Main Results:

  • The incidence of postoperative VTE was 0.10% (378 out of 361,384 patients).
  • Significant risk factors for VTE included American Society of Anesthesiologists (ASA) class II or greater, age 16-18 years, non-elective surgery, general surgery, cardiothoracic surgery, and longer operative time (p<0.001 for all).
  • A majority of adverse events were associated with an increased risk of subsequent VTE (p<0.001).

Conclusions:

  • Postoperative VTE occurs in 0.10% of the pediatric surgical population.
  • Specific patient demographics, surgical factors, and perioperative adverse events are significantly associated with VTE development in children.
Abstract

Keywords:
outcomes researchpediatric surgery

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