Related Experiment Video
Updated: Jun 24, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Hospital acquired venous thromboembolism in children with sickle cell disease
Shreya Agarwal1, Kayla L Foster2,3, Shaniqua J Anum2,3
1Department of Pediatrics, Division of Hematology, University of California, San Francisco, California, USA.
Insights
Hospitalization for sickle cell disease (SCD) increases venous thromboembolic event (VTE) risk, particularly with acute chest syndrome, ICU admission, or central venous catheters. Further research is needed to confirm these findings in pediatric SCD patients.
Area of Science:
- Hematology
- Pediatric Thrombosis
- Vascular Medicine
Background:
- Sickle cell disease (SCD) is a known hypercoagulable state.
- The risk and predictors of hospital-acquired venous thromboembolic events (VTE) in children with SCD are not well-defined.
- Identifying high-risk subgroups could inform thromboprophylaxis strategies.
Purpose of the Study:
- To describe the clinical characteristics of hospital-acquired VTE in patients with SCD younger than 21 years.
- To determine the outcomes and recurrence rates of VTE in this pediatric SCD population.
- To identify risk factors associated with VTE during hospitalization in children and young adults with SCD.
Main Methods:
- Single-center retrospective study.
- Data extracted from electronic medical records (2011-2021) for patients <21 years with SCD.
- Analysis included demographics, admission reason, VTE location, risk factors (central venous catheter [CVC], intensive care unit [ICU] admission), outcomes, and recurrence.
Main Results:
- A total of 20 VTE events were identified over 10 years.
- VTE was most common in HbSS/HbSβThal0 genotypes (70%) and associated with acute chest syndrome (ACS) (70%), ICU admissions (50%), and CVC use (55%).
- One patient died from VTE; one experienced recurrence at 13 months.
Conclusions:
- In pediatric patients with SCD, ICU admission, ACS, and CVC presence are associated with an increased risk of VTE.
- These findings suggest potential targets for VTE risk stratification and prevention in hospitalized children with SCD.
- Larger, multi-center studies are required to validate these observations and guide thromboprophylaxis decisions.
Abstract:
Sickle cell disease (SCD) is well recognized as a hypercoagulablestate, however, it remains unclear whether a subgroup of children with SCD at higher risk of venous thromboembolic event (VTE) during hospitalization may benefit from thromboprophylaxis. Our objectives were to describe the clinical characteristics, outcomes and recurrence of hospital acquired VTE in patients with SCD younger than 21 years. This was a single center retrospective study. Data regarding demographics, reason for admission, location of VTE, risk factors like central venous catheter (CVC), intensive care unit (ICU) admission among others were extracted from electronic medical records over a 10-year study period (2011-2021). Recurrence of VTE at 1 and 5 years was assessed. Descriptive statistics were used as indicated. We identified a total of 20 VTE events over the 10-year study period. Six of these events occurred in those younger than 12 years of age. Fourteen (70%) VTE events occurred in the HbSS or HbSβThal0 genotypes compared to 6 (30%) in HbSC. Most common VTE was isolated pulmonary embolism (PE) (n = 10, 50%). VTE were most often associated with acute chest syndrome (ACS) (n = 14, 70%), ICU admissions (n = 10, 50%) and CVC (n = 5/9, 55%). One patient died from the VTE event. One patient with additional underlying risk factors had a recurrent VTE at 13 months. Our study suggests that ICU admission, ACS and presence of CVC increases the risk of VTE in children and young adults with SCD, but larger studies are indicated to validate our findings.
