Risk factors for venous thromboembolism after pediatric trauma

Casey J. Allen, Clark R. Murray, Jonathan P. Meizoso, Juliet J. Ray, Holly L. Neville, Carl I. Schulman, Nicholas Namias, Juan E. Sola, Kenneth G. Proctor

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background/purpose The purposes of this study were to identify independent predictors of venous thromboembolism (VTE), to evaluate the relative impact of adult VTE risk factors, and to identify a pediatric population at high-risk for VTE after trauma. Methods 1934 consecutive pediatric admissions (> 17 years) from 01/2000 to 12/2012 at a level 1 trauma center were reviewed. Logistic regression was used to identify predictors of VTE. Results Twenty-two patients (1.2%) developed a VTE, including 5% of those requiring orthopedic surgery, 14% of those with major vascular injury (MVI), and 36% of those with both. Most (84%) were diagnosed at the primary site of injury. 86% of those who developed a VTE were receiving thromboprophylaxis at the time of diagnosis. Independent predictors were age (odds ratio (OR): 1.59, 95% confidence interval (CI): 1.11-2.25), orthopedic surgery (OR: 8.10, CI: 3.10-21.39), transfusion (OR: 3.37, CI: 1.26-8.99), and MVI (OR: 15.43, CI: 5.70-41.76). When known risk factors for VTE in adults were adjusted, significant factors were age ≥ 13 years (OR: 9.16, CI: 1.08-77.89), indwelling central venous catheter (OR: 4.41, CI: 1.31-14.82), orthopedic surgery (OR: 6.80, CI: 2.47-18.74), and MVI (OR: 14.41, CI: 4.60-45.13). Conclusion MVI and orthopedic surgery are synergistic predictors of pediatric VTE. Most children who developed a VTE were receiving thromboprophylaxis at the time of diagnosis.

Original languageEnglish (US)
Pages (from-to)168-171
Number of pages4
JournalJournal of Pediatric Surgery
Volume51
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Children
  • DVT
  • Deep vein thrombosis
  • Pediatrics
  • Trauma
  • VTE

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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