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Incidence and risk factors for postthrombotic syndrome in neonates and children in a single-center cohort study

Irene Klaassen1, Sahinde Sari1, Heleen van Ommen2

  • 1Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.

Journal of Thrombosis and Haemostasis : JTH
|October 10, 2024
PubMed

Insights

Postthrombotic syndrome (PTS) occurs frequently in children after deep vein thrombosis (DVT), with higher rates in older children. Risk factors and protective elements for PTS vary significantly between neonates and older children.

Area of Science:

  • Pediatric Medicine
  • Vascular Medicine
  • Clinical Research

Background:

  • Postthrombotic syndrome (PTS) is a chronic complication following deep vein thrombosis (DVT), characterized by limb pain, swelling, and functional impairment.
  • The incidence and specific risk factors for PTS in pediatric populations remain poorly understood.

Purpose of the Study:

  • To determine the incidence of PTS in neonates and children following DVT.
  • To identify distinct risk factors and protective elements for PTS in these age groups.

Main Methods:

  • An observational cohort study included all pediatric patients (≤18 years) diagnosed with DVT between 2001 and 2021.
  • PTS diagnosis was confirmed using the modified Villalta scale, with separate analyses for neonates (≤2 months) and older children (>2 months).

Main Results:

  • The 20-year PTS incidence was 20.0% in neonates and 40.0% in children.
  • In neonates, risk factors included multi-vessel involvement and incomplete thrombus resolution.
  • In children, risk factors included multi-vessel involvement, recurrent DVT, and incomplete thrombus resolution; regular exercise, central venous catheter-related DVT, and provoked DVT were protective.

Conclusions:

  • Pediatric PTS has a high incidence, with differing risk profiles between neonates and children.
  • These findings underscore the need for tailored prevention and management strategies for PTS in pediatric patients based on age and specific clinical factors.
Abstract

Keywords:
deep vein thrombosisincidencepediatricspostthrombotic syndromerisk factors

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