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Hospital-associated venous thromboembolism in children: incidence and clinical characteristics.

Publication ,  Journal Article
Takemoto, CM; Sohi, S; Desai, K; Bharaj, R; Khanna, A; McFarland, S; Klaus, S; Irshad, A; Goldenberg, NA; Strouse, JJ; Streiff, MB
Published in: J Pediatr
February 2014

OBJECTIVE: To determine incidence and clinical characteristics of hospital-associated venous thromboembolism (VTE) in pediatric patients. STUDY DESIGN: A retrospective analysis of patients with hospital-associated VTE at the Johns Hopkins Hospital from 1994 to 2009 was performed. Clinical characteristics of patients aged 21 years and younger who developed VTE symptoms after 2 days of hospitalization or <90 days after hospital discharge were examined. International Classification of Diseases, Ninth Revision codes were used to categorize patients with complex chronic medical conditions and trauma. RESULTS: There were 270 episodes of hospital-associated VTE in 90,485 admissions (rate 30 per 10,000 admissions). Young adults (18-21 years) and adolescents (14-17 years) had significantly increased rates of VTE compared with children (2-9 years) (incidence rate ratio [IRR] 7.7, 95% CI 5.1-12.0; IRR 4.3, 95% CI 2.7-6.8, respectively). A central venous catheter (CVC) was present in 50% of patients, and a surgical procedure was performed in 45% of patients before VTE diagnosis. For patients without a CVC, trauma was the most common admitting diagnosis. CVC-related VTE was diagnosed most frequently in infants (<1 year old) and in patients with malignancy. Renal and cardiac diseases were associated with the highest rates of VTE (51 and 48 per 10,000, respectively). Rates were significantly higher among those with ≥ 4 medical conditions compared with those with 1 medical condition (IRR 4.0, 95% CI 1.4-8.9). CONCLUSION: Older age and multiple medical conditions were associated with increased rates of hospital-associated VTE. These data can contribute to the design of future clinical trials to prevent hospital-associated VTE in high-risk children.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

February 2014

Volume

164

Issue

2

Start / End Page

332 / 338

Location

United States

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Venous Thromboembolism
  • United States
  • Retrospective Studies
  • Prognosis
  • Pediatrics
  • Neoplasms
  • Male
  • Kidney Diseases
 

Citation

APA
Chicago
ICMJE
MLA
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Takemoto, C. M., Sohi, S., Desai, K., Bharaj, R., Khanna, A., McFarland, S., … Streiff, M. B. (2014). Hospital-associated venous thromboembolism in children: incidence and clinical characteristics. J Pediatr, 164(2), 332–338. https://doi.org/10.1016/j.jpeds.2013.10.025
Takemoto, Clifford M., Sajeet Sohi, Kruti Desai, Raman Bharaj, Anuj Khanna, Susan McFarland, Sybil Klaus, et al. “Hospital-associated venous thromboembolism in children: incidence and clinical characteristics.J Pediatr 164, no. 2 (February 2014): 332–38. https://doi.org/10.1016/j.jpeds.2013.10.025.
Takemoto CM, Sohi S, Desai K, Bharaj R, Khanna A, McFarland S, et al. Hospital-associated venous thromboembolism in children: incidence and clinical characteristics. J Pediatr. 2014 Feb;164(2):332–8.
Takemoto, Clifford M., et al. “Hospital-associated venous thromboembolism in children: incidence and clinical characteristics.J Pediatr, vol. 164, no. 2, Feb. 2014, pp. 332–38. Pubmed, doi:10.1016/j.jpeds.2013.10.025.
Takemoto CM, Sohi S, Desai K, Bharaj R, Khanna A, McFarland S, Klaus S, Irshad A, Goldenberg NA, Strouse JJ, Streiff MB. Hospital-associated venous thromboembolism in children: incidence and clinical characteristics. J Pediatr. 2014 Feb;164(2):332–338.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

February 2014

Volume

164

Issue

2

Start / End Page

332 / 338

Location

United States

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Venous Thromboembolism
  • United States
  • Retrospective Studies
  • Prognosis
  • Pediatrics
  • Neoplasms
  • Male
  • Kidney Diseases