Faculty Collaboration Database

Venous thromboembolism in children with cystic fibrosis: Retrospective incidence and intrapopulation risk factors. Thromb Res 2017 Oct;158:161-166

Date

09/22/2017

Pubmed ID

28934665

DOI

10.1016/j.thromres.2017.08.022

Scopus ID

2-s2.0-85029534206 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

INTRODUCTION: Pediatric venous thromboembolism (VTE) is a rare but serious medical condition. Cystic fibrosis (CF) is a risk for recurrent pediatric VTE and has potential thrombophilic tendency. However, much remains unknown, including incidence and intrapopulation risk factors.

METHODS: A retrospective cohort of pediatric CF patients followed at Children's Hospital Colorado from January 1st 2003 through May 20th 2016 was examined. Cases were identified by informatics and validated manually. Data on CF severity, co-morbidities and treatment, central venous catheter (CVC) use, and thrombophilia were obtained from an institutional CF database and chart review.

RESULTS: Nineteen VTE occurred in 458 participants followed for 3595 person-years, yielding an incidence rate of 53 VTE per 10,000 children with CF. VTE cases had additional co-morbidities including CF-related diabetes (p=0.002) and sinus disease (p=0.04), more total admissions (p<0.001), admit days (p<0.001), positive respiratory cultures (p<0.001), pseudomonas infections (p<0.001), steroid courses (p=0.001), and total CVC days (PICC p=0.03, port p=0.007). On univariate analysis, older age (RR 1.162, p=0.007), sinus disease (RR 2.62, p=0.05), longer hospital stay (RR 1.03, p<0.001), higher ESR (RR 1.02, p=0.03) and CRP (RR 1.07, p=0.007), and an absence of systemic steroids (RR 0.19, p=0.004) increased the risk of VTE.

CONCLUSIONS: In this cohort, children with CF had a higher incidence of VTE when compared to the previously reported incidence in the overall pediatric population at Children's Hospital Colorado. Overall, those with VTE had a greater disease burden and older age, sinus disease, longer hospitalization and increased inflammation were VTE risk factors.

Author List

Knight-Perry J, Branchford BR, Thornhill D, Martiniano SL, Sagel SD, Wang M

Author

Brian Branchford MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Child
Child, Preschool
Cystic Fibrosis
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Retrospective Studies
Risk Factors
Venous Thromboembolism
Young Adult