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Published on: November 26, 2013
Evaluation of Thromboembolic Events in Patients Hospitalized in the Palliative Care Unit: A Single Center Experience
Zeliha Güzelküçük1, Hatice Dilara Aydoğdu2, Ganime Ayar3
1Department of Pediatrics, Division of Pediatric Hematology and Oncology, Ankara Bilkent City Hospital, Ankara, Turkey.
Insights
Pediatric palliative care patients have a high thrombosis rate of approximately 18.4%. Catheter-related thrombosis was common, with malignancy and trauma as leading diagnoses. Prophylactic anticoagulation may benefit high-risk groups.
Area of Science:
- Pediatric Hematology
- Palliative Care Medicine
- Thrombosis Research
Background:
- Thromboembolic events are less common in children than adults but are increasing due to advanced care for chronic illnesses.
- Improved survival in pediatric chronic illnesses necessitates understanding associated complications like thrombosis.
Purpose of the Study:
- To evaluate the incidence and characteristics of thromboembolic events in pediatric patients admitted to a Palliative Care Unit (PCU).
Main Methods:
- Retrospective analysis of 1002 hospitalizations in 449 pediatric patients from January 2020 to January 2023.
- Examination of patient records to identify and characterize thromboembolic events.
Main Results:
- 18.4% of pediatric PCU patients (83 out of 449) experienced thrombosis.
- Malignancy and trauma were the most frequent primary diseases associated with thrombosis.
- Catheter-related thrombosis was a common finding; treatments included low-molecular-weight heparin (LMWH).
Conclusions:
- The frequency of thrombosis in pediatric PCU patients is significantly higher than general childhood rates.
- Malignancy and trauma are key risk factors for thrombosis in this population.
- Consideration of prophylactic anticoagulation is recommended for specific high-risk pediatric PCU patient groups.
Objectives:
Although thromboembolic events are less common in children compared with adults, complications related to thromboembolism are becoming more frequent due to improved care for children with chronic illnesses. The aim of the study was to evaluate thromboembolic events in pediatric patients hospitalized in palliative care unit (PCU).
Materials And Methods:
The files of the patients who were hospitalized in PCU of our hospital between January 2020 and January 2023 were retrospectively analyzed. A total of 1002 hospitalizations of 449 patients were examined.
Results:
The median age was 6.1 years, F/M: 214/235. We found that 83 (18.4%) patients had thrombosis. In most patients with thrombosis, the primary diseases were malignancy and trauma. During hospitalization, the median time for detecting thrombosis was 26 days (range: 1 to 180 d). We treated 67 out of 83 thrombosis patients with low-molecular-weight heparin (LMWH) for an average of 26 days, ranging from 1 to 188 days. Unfractionated heparin was used in 2 patients, while thrombolytic therapy was used in 2 patients with massive pulmonary embolism and middle cerebral artery thrombosis. None of the thromboembolic events resulted in fatality.
Conclusions:
This study revealed that the frequency of thrombosis in pediatric patients hospitalized in PCU was ∼1/5, which is significantly higher than the rates observed in childhood. Catheter-related thrombosis was more frequently observed among patients with thrombosis in the PCU, with malignancy and trauma representing the most common indications for hospitalization. Our findings suggest that certain patient groups should be evaluated for prophylactic anticoagulation.
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