Original ArticleHospital-Associated Venous Thromboembolism in Children: Incidence and Clinical Characteristics
Section snippets
Methods
We performed a chart review of pediatric patients (aged ≤21 years) who were hospitalized at the Johns Hopkins Hospital from 1994 to 2009. We identified patients with VTE using International Classification of Diseases, Ninth Revision (ICD-9) codes for DVT (451.11, 451.19, 45.12, 451.81, 451.82, 451.83, 451.84, 451.89, 451.9, 453.2, 453.8, 453.9, 671.30, 671.31, 671.33, 671.40, 671.42, 671.44, 671.90, 671.91, 671.92, 671.93, 671.94) and PE (415.11, 415.19, 634.6, 634.61, 634.62, 635.60, 635.61,
Results
We identified 238 patients who were 21 years and younger with 270 episodes of hospital-associated VTE among 90 485 total patient admissions from 1994 to 2009. This resulted in a total rate of 30 per 10 000 admissions, or 0.3%. One hundred eighty-five episodes of VTE were diagnosed within 90 days of a hospital discharge (rate of 20 per 10 000 or 0.2%); in 203 episodes, VTE was diagnosed after 2 days of hospital admission (rate of 22 per 10 000 or 0.2%). Hospital-associated VTE comprised 60% of
Discussion
Using the definition of hospital-associated VTE as that diagnosed ≥2 days after hospital admission, or VTE diagnosis within 90 days of hospital discharge, we found an incidence of 30 episodes per 10 000 admissions. This rate compares with an overall incidence of VTE of 19-58 episodes per 10 000 hospitalizations that has been reported in recent studies in children using national data sets.3, 4, 5 We included the patients with VTE diagnosis after discharge from the hospital, because risk of
References (27)
- et al.
Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest
(2008) - et al.
Determination of risk factors for deep venous thrombosis in hospitalized children
J Pediatr Surg
(2008) - et al.
Venous thromboembolism and adolescent and young adult oncology inpatients in US children's hospitals, 2001 to 2008
J Pediatr
(2011) - et al.
Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE
Blood
(1994) - et al.
Incidence, risk factors, and treatment patterns for deep venous thrombosis in hospitalized children: an increasing population at risk
J Vasc Surg
(2008) - et al.
Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey
J Pediatr
(2004) - et al.
Validation of a predictive model for identifying an increased risk for thromboembolism in children with acute lymphoblastic leukemia: results of a multicenter cohort study
Blood
(2010) - Prevention of Hospital-Acquired Venous Thromboembolism (HA-VTE) Expert Panel meeting. Centers for Disease Control and...
- et al.
Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007
Pediatrics
(2009) - et al.
Pediatric venous thromboembolism in the United States: a tertiary care complication of chronic diseases
Pediatr Blood Cancer
(2012)
Risk factors for venous thrombosis: current understanding from an epidemiological point of view
Br J Haematol
Effect of injury severity on the incidence and utilization-related outcomes of venous thromboembolism in pediatric trauma inpatients
Pediatr Crit Care Med
In the absence of a central venous catheter, risk of venous thromboembolism is low in critically injured children, adolescents, and young adults: evidence from the National Trauma Data Bank
Pediatr Crit Care Med
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The authors declare no conflicts of interest.