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Published on: July 13, 2019
Risk factors for venous thromboembolism in a single pediatric intensive care unit in China
Jintuo Zhou1, Yanting Zhu1, Ying Liu1
1Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, #18 Daoshan Road, Fuzhou, China.
Insights
Pediatric venous thromboembolism (VTE) affects 0.19% of children, with shock and sepsis being significant risk factors. This study highlights the need for more research on VTE in Chinese pediatric populations.
Area of Science:
- Pediatric critical care medicine
- Hematology
- Epidemiology
Background:
- Rising prevalence of venous thromboembolism (VTE) in critically ill children globally.
- Limited epidemiological data on childhood VTE in Chinese populations.
- Need for studies focusing on diverse ethnic and geographic groups.
Purpose of the Study:
- To determine the prevalence and identify risk factors for pediatric VTE in China.
- To analyze sociodemographic and clinical factors associated with VTE in critically ill children.
- To address the gap in VTE research within the Chinese pediatric population.
Main Methods:
- Retrospective cohort study using the Pediatric Intensive Care (PIC) database (2010-2018).
- Data extraction via SQL and pgAdmin4.
- Bivariate analyses (chi-square, Student's t-test) and multivariable logistic regression.
Main Results:
- Study included 12,881 pediatric patients; VTE incidence was 0.19%.
- Most common VTE location: deep venous thrombosis (DVT) in extremities (n=18).
- Shock (aOR: 6.77) and sepsis admission (aOR: 6.09) were significant risk factors for pediatric VTE.
Conclusions:
- Pediatric VTE prevalence in the PIC database is 0.19%.
- Deep venous thrombosis (DVT) of the extremities is the most frequent VTE location.
- Shock and sepsis are statistically significant independent risk factors associated with pediatric VTE.
Background:
Analyses of extensive, nationally representative databases indicate a rising prevalence of venous thromboembolism (VTE) among critically ill children. However, the majority of studies on childhood VTE have primarily concentrated on Caucasian populations in the United States and European countries. There is a lack of epidemiological studies on VTE in Chinese children.
Methods:
We conducted a retrospective cohort study of data from the Pediatric Intensive Care (PIC) database. Data were obtained and extracted by using Structured Query Language (SQL) and the administrative platform pgAdmin4 for PostgreSQL. Bivariate analyses were conducted in which categorical variables were analyzed by a chi-square test and continuous variables were analyzed by a Student's t-test. Separate multivariable logistic regressions were employed to investigate the associations between VTE and sociodemographic factors as well as clinical factors.
Results:
Our study included 12,881 pediatric patients from the PIC database, spanning the years 2010 to 2018. The incidence rate of pediatric VTE was 0.19% (24/12,881). The venous thrombotic locations were deep venous thrombosis extremities (n = 18), superior vena cava (n = 1), cerebral sinovenous (n = 1), and other deep venous thrombosis (n = 4). Univariate analysis showed that age, weight, shock, sepsis, cancer and vasopressor receipt were statistically significant risk factors for pediatric VTE (all p ≤ 0.05). After multivariable logistic regression analysis, only shock (aOR: 6.77, 95%CI: 1.33-34.73, p = 0.019) and admission for sepsis (aOR: 6.09, 95%CI: 1.76-21.09, p = 0.004) were statistically significant associated with pediatric VTE.
Conclusions:
In conclusion, data obtained from the Pediatric Intensive Care (PIC) database revealed a prevalence of VTE in pediatric patients of 0.19%. The most common location for venous thrombi was deep venous thrombosis (DVT) in the extremities. We identified that shock and sepsis were statistically significant factors associated with pediatric VTE.
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