Incidence and risk factors for venous thromboembolism in critically ill children with cardiac disease. Pediatr Cardiol 2012 Jan;33(1):103-8
Date
09/20/2011Pubmed ID
21927987DOI
10.1007/s00246-011-0098-2Scopus ID
2-s2.0-84863487235 (requires institutional sign-in at Scopus site) 42 CitationsAbstract
Cardiac disease is a risk factor for venous thromboembolism (VTE) in children. In this study, we investigated the incidence and risk factors of VTE in critically ill children with cardiac disease, who were prospectively followed-up for VTE after admission to a tertiary care pediatric intensive care unit (PICU). Risk factors were compared between VTE cases and (1) patients in the cohort who did not develop VTE and (2) the next three cardiac patients sequentially admitted to the PICU (case control). Forty-one cases of VTE were identified from 1070 admissions (3.8%). Thirty-seven percent of VTE cases were central venous catheter (CVC)-associated, and 56% of cases were intracardiac. Sixty-six percent of patients were receiving anticoagulation at the time of VTE diagnosis. Increased VTE incidence was associated with unscheduled PICU admission, age <6 months, extracorporeal membrane oxygenation, increased number of CVCs, increased number of CVC days, higher risk of mortality score, and longer PICU stay. Using logistic regression, VTE was associated with single-ventricle physiology (odds ratio [OR] 11.2, 95% CI 3.0-41.9), widened arterial-to-somatic oxygen saturation gradient (SpO(2)-rSO(2) >30) (OR 4.3, 95% CI 1.1-16), and more CVC days (OR 1.1, 95% CI 1.04-1.13). Risk factors for VTE in critically ill children with cardiac disease include younger age, single-ventricle cardiac lesions, increased illness severity, unscheduled PICU admission, and complicated hospital course.
Author List
Hanson SJ, Punzalan RC, Christensen MA, Ghanayem NS, Kuhn EM, Havens PLAuthor
Rowena C. Punzalan MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Anticoagulants
Child
Child, Preschool
Critical Illness
Female
Follow-Up Studies
Heart Diseases
Humans
Incidence
Infant
Intensive Care Units, Pediatric
Logistic Models
Male
Middle Aged
Retrospective Studies
Risk Factors
Venous Thromboembolism
Young Adult
