Risk factors for venous thromboembolism after pediatric trauma

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

Research output: Contribution to journalArticle

12 Citations (Scopus)

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

Fingerprint

Venous Thromboembolism
Pediatrics
Odds Ratio
Confidence Intervals
Wounds and Injuries
Vascular System Injuries
Orthopedics
Indwelling Catheters
Central Venous Catheters
Trauma Centers
Age Factors
Logistic Models

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Risk factors for venous thromboembolism after pediatric trauma. / Allen, Casey J.; Murray, Clark R.; Meizoso, Jonathan P.; Ray, Juliet J.; Neville, Holly; Schulman, Carl I; Namias, Nicholas; Sola, Juan E; Proctor, Kenneth G.

In: Journal of Pediatric Surgery, Vol. 51, No. 1, 01.01.2016, p. 168-171.

Research output: Contribution to journalArticle

Allen, Casey J. ; Murray, Clark R. ; Meizoso, Jonathan P. ; Ray, Juliet J. ; Neville, Holly ; Schulman, Carl I ; Namias, Nicholas ; Sola, Juan E ; Proctor, Kenneth G. / Risk factors for venous thromboembolism after pediatric trauma. In: Journal of Pediatric Surgery. 2016 ; Vol. 51, No. 1. pp. 168-171.
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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.",
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T1 - Risk factors for venous thromboembolism after pediatric trauma

AU - Allen, Casey J.

AU - Murray, Clark R.

AU - Meizoso, Jonathan P.

AU - Ray, Juliet J.

AU - Neville, Holly

AU - Schulman, Carl I

AU - Namias, Nicholas

AU - Sola, Juan E

AU - Proctor, Kenneth G

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N2 - 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.

AB - 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.

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