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Abstract

The risk of deep vein thrombosis (DVT) among hospitalized children is rising.The optimal approach to DVT prophylaxis in children is unclear. This study set out to ascertain the prevalence of DVT among pediatric inpatients who neither have contraindications to nor absolute indications for prophylactic therapy. A prospective surveillance of at-risk children plus a retrospective chart review were conducted. Patients were considered to be at risk after the first 2 days of their admission. Of 1,637patients reviewed, 198 patients met criteria; among these, 84% did not receive prophylaxis. Of 2,354 observed days at risk for nonprophylaxed patients (including days at risk prior to initiating prophylaxis among prophlyaxed patients), there were 9 DVT events, for a rate 3.82/1,000 days observed. A total of 31 patients received prophylaxis. Three of these patients experienced a DVT. One patient had a bleeding event, hematuria. These results describe patients who may be eligible for prophylaxis and should be screened for further risk factors.

Keywords

deep vein thrombosis pediatrics anticoagulation prophylaxis

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References

Dix, D. , Andrew, M. , Marzinotto, V. , Charpentier, K. , Bridge, S. , Monagle, P. , . . . Massicotte, P. (2000). The use of low molecular weight heparin in pediatric patients: A prospective cohort study. Journal of Pediatrics, 136, 439-445.

The Joint Commission. (2008). 2008 National patient safety goals: Hospital. Retrieved from http://www.jointcommission.org/NR/rdonlyres/82B717D8-B16A-4442-AD00-CE3188C2F00A/0/08_HAP_NPSGs_Master.pdf

Massicotte, M.P. , Dix, D. , & Monagle, P. ( 1998). Central venous catheter related thrombosis (CVL-related DVT) in children: analysis of the Canadian Registry of Venous Thromboembolic Complications. Journal of Pediatrics, 133, 770-776.

McBride, W. , Gadowski, G. , Keller, M. , & Vane, D. ( 1994). Pulmonary embolism in pediatric trauma patients. Journal of Trauma, 37, 913-915.

Monagle, P. , Michelson, A. , Bovill, E. , & Andrew, M. ( 2001). Antithrombotic therapy in children. Chest, 119, 344S-370S.

Morgan, J. ( 2007). Perioperative venous thrombosis in children: Is it time for primary prophylaxis? Paediatric Anaesthesia, 17, 99-101.

Raffini, L. , Huang, Y.-S. , Witmer, C. , & Feudtner, C. ( 2009). A dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001 to 2007. Pediatrics , 124, 1001-1008.

Ronguhe, M.D. , Halsey, C. , & Goulden, N.J. ( 2003). Anticoagulation therapy in children. Pediatric Drugs, 5, 803-820.

Sandoval, J.A. , Sheehan, M.P. , Stonerock, C.E. , Shafique, S. , Rescorla, F.J. , & Dalsing, M.C. ( 2008). Incidence, risk factors, and treatment patterns for deep venous thrombosis in hospitalized children: An increasing population at risk . Journal of Vascular Surgery, 47, 837-843.

10.

Truitt, A.K. , Sorrells, D.L. , Halvorson, E. , Starring, J. , Kurkchubasche, A.G. , Tracy, T.F. , & Luks, F.L. ( 2005). Pulmonary embolism: Which trauma patients are at risk ? Journal of Pediatric Surgery, 40, 124-127.

11.

Vavilala, M. , Nathens, A. , Jurkovich, G. , Mackenzie, E. , & Rivara, F. ( 2002). Risk factors for venous thromboembolism in pediatric trauma. Journal of Trauma Injury, Infection and Critical Care , 52, 922-927.

Observational Cohort Study of Pediatric Inpatients With Central Venous Catheters at “Intermediate Risk” of Thrombosis and Eligible for Anticoagulant Prophylaxis

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