Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium
Abstract Background Surgery is a known risk factor for hospital‐acquired venous thromboembolism (HA‐VTE) in children. Objectives To assess whether the odds of HA‐VTE differs across six anatomic sites of noncardiac surgery and to identify risk factors for HA‐VTE in these children. Methods This was a...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12810 |
| _version_ | 1797757596674818048 |
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| author | Elizabeth T. Stephens Anh Thy H. Nguyen Julie Jaffray Brian Branchford Ernest K. Amankwah Neil A. Goldenberg E. Vincent S. Faustino Neil A. Zakai Amy Stillings Emily Krava Guy Young John H. Fargo |
| author_facet | Elizabeth T. Stephens Anh Thy H. Nguyen Julie Jaffray Brian Branchford Ernest K. Amankwah Neil A. Goldenberg E. Vincent S. Faustino Neil A. Zakai Amy Stillings Emily Krava Guy Young John H. Fargo |
| author_sort | Elizabeth T. Stephens |
| collection | DOAJ |
| description | Abstract Background Surgery is a known risk factor for hospital‐acquired venous thromboembolism (HA‐VTE) in children. Objectives To assess whether the odds of HA‐VTE differs across six anatomic sites of noncardiac surgery and to identify risk factors for HA‐VTE in these children. Methods This was a multicenter, case–control study. Anatomic sites of surgery and risk factors for HA‐VTE were collected on hospitalized pediatric patients who had undergone a single noncardiac surgery and developed HA‐VTE (cases), and those who did not develop HA‐VTE (controls), via the Children's Hospital‐Acquired Thrombosis (CHAT) Registry. Logistic regression estimated the odds ratio (OR) and 95% confidence intervals (CIs) between six anatomic sites of surgery and 16 putative HA‐VTE risk factors. Variables with a p value of 0.10 or less in unadjusted analyses were included in adjusted models for further evaluation. The final model used backward selection, with a significance level of 0.05. Results From January 2012 to March 2020, 163 cases (median age, 5.7 years; interquartile range [IQR], 0.3–14.2) and 208 controls (median age of 7.5 years; IQR, 3.7–12.9) met our criteria. There was no statistically significant increased odds of VTE among the types of noncardiac surgery. In the final adjusted model, central venous catheter (CVC; OR, 14.69; 95% CI, 7.06–30.55), intensive care unit (ICU) stay (OR, 5.31; 95% CI, 2.53–11.16), and hospitalization in the month preceding surgery (OR, 2.75; 95% CI, 1.24–6.13) were each independently significant risk factors for HA‐VTE. Conclusion In children undergoing noncardiac surgery, placement of CVCs, admission/transfer to the ICU, or hospitalization in the month prior to surgery were positively associated with HA‐VTE. |
| first_indexed | 2024-03-12T18:18:06Z |
| format | Article |
| id | doaj.art-4f365fb8047e4561910d727b85afc271 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T18:18:06Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-4f365fb8047e4561910d727b85afc2712023-08-02T09:02:44ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792022-10-0167n/an/a10.1002/rth2.12810Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortiumElizabeth T. Stephens0Anh Thy H. Nguyen1Julie Jaffray2Brian Branchford3Ernest K. Amankwah4Neil A. Goldenberg5E. Vincent S. Faustino6Neil A. Zakai7Amy Stillings8Emily Krava9Guy Young10John H. Fargo11Northern Light Health, Eastern Maine Medical Center Bangor Maine USAUniversity of South Florida Tampa Florida USAChildren's Hospital Los Angeles Los Angeles California USAVersiti Blood Research Institute Milwaukee Wisconsin USAOncology Johns Hopkins All Children's Hospital Saint Petersburg Florida USAAll Children's Hospital Johns Hopkins Medicine All Children's Research Institute St. Petersburg Florida USADepartment of Pediatrics Yale School of Medicine New Haven Connecticut USAMedicine University of Vermont College of Medicine Colchester Vermont USAChildren's Hospital Los Angeles Los Angeles California USAChildren's Hospital Los Angeles Los Angeles California USAChildren's Hospital Los Angeles Los Angeles California USAAkron Children's Hospital Akron Ohio USAAbstract Background Surgery is a known risk factor for hospital‐acquired venous thromboembolism (HA‐VTE) in children. Objectives To assess whether the odds of HA‐VTE differs across six anatomic sites of noncardiac surgery and to identify risk factors for HA‐VTE in these children. Methods This was a multicenter, case–control study. Anatomic sites of surgery and risk factors for HA‐VTE were collected on hospitalized pediatric patients who had undergone a single noncardiac surgery and developed HA‐VTE (cases), and those who did not develop HA‐VTE (controls), via the Children's Hospital‐Acquired Thrombosis (CHAT) Registry. Logistic regression estimated the odds ratio (OR) and 95% confidence intervals (CIs) between six anatomic sites of surgery and 16 putative HA‐VTE risk factors. Variables with a p value of 0.10 or less in unadjusted analyses were included in adjusted models for further evaluation. The final model used backward selection, with a significance level of 0.05. Results From January 2012 to March 2020, 163 cases (median age, 5.7 years; interquartile range [IQR], 0.3–14.2) and 208 controls (median age of 7.5 years; IQR, 3.7–12.9) met our criteria. There was no statistically significant increased odds of VTE among the types of noncardiac surgery. In the final adjusted model, central venous catheter (CVC; OR, 14.69; 95% CI, 7.06–30.55), intensive care unit (ICU) stay (OR, 5.31; 95% CI, 2.53–11.16), and hospitalization in the month preceding surgery (OR, 2.75; 95% CI, 1.24–6.13) were each independently significant risk factors for HA‐VTE. Conclusion In children undergoing noncardiac surgery, placement of CVCs, admission/transfer to the ICU, or hospitalization in the month prior to surgery were positively associated with HA‐VTE.https://doi.org/10.1002/rth2.12810HospitalsPediatricSurgeryThrombosisVenous thromboembolism |
| spellingShingle | Elizabeth T. Stephens Anh Thy H. Nguyen Julie Jaffray Brian Branchford Ernest K. Amankwah Neil A. Goldenberg E. Vincent S. Faustino Neil A. Zakai Amy Stillings Emily Krava Guy Young John H. Fargo Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium Research and Practice in Thrombosis and Haemostasis Hospitals Pediatric Surgery Thrombosis Venous thromboembolism |
| title | Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium |
| title_full | Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium |
| title_fullStr | Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium |
| title_full_unstemmed | Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium |
| title_short | Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital‐Acquired Thrombosis consortium |
| title_sort | risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery a report from the children s hospital acquired thrombosis consortium |
| topic | Hospitals Pediatric Surgery Thrombosis Venous thromboembolism |
| url | https://doi.org/10.1002/rth2.12810 |
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