High Rate of Venous Thromboembolism in Severe Pediatric Intestinal Failure
Copyright © 2022 Elsevier Inc. All rights reserved..
OBJECTIVE: To quantify the rate of venous thromboembolism (VTE) in patients with pediatric intestinal failure and identify associated risk factors.
STUDY DESIGN: We performed a retrospective cohort study in pediatric patients (<21 years old) with severe pediatric intestinal failure (≥90 consecutive days of parenteral nutrition) secondary to short bowel syndrome who were treated from 2014 to 2021 at an interdisciplinary intestinal rehabilitation program. The primary outcome was the incidence of VTE. Multivariable regression was performed to identify independent clinical predictors of VTE.
RESULTS: A total of 263 patients (59.7% male) met the criteria for inclusion. The cumulative incidence of VTE was 28.1%, with a rate of 0.32 VTEs per 1000 catheter-days. On univariate analysis, the number of catheter days, number of catheters, and history of central line-associated blood stream infection were associated with VTE. On multivariable logistic regression, a higher number of catheters was an independent risk factor for VTE (aOR, 1.17; 95% CI, 1.06-1.29). Additionally, earlier gestational age was a risk factor for VTE such that every week decrease in gestational age conferred a 9% increased risk of VTE (aOR, 1.09; 95% CI, 1.02-1.16).
CONCLUSIONS: In this retrospective study, 28.1% of patients with severe pediatric intestinal failure developed VTE; the number of catheters and early gestational age were noted to be independent risk factors for VTE. This high incidence of VTE highlights the need to investigate VTE in pediatric intestinal failure prospectively, including the potential benefit of prophylactic anticoagulation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:253 |
|---|---|
| Enthalten in: |
The Journal of pediatrics - 253(2023) vom: 21. Feb., Seite 152-157 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Keefe, Gregory [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anticoagulation |
|---|
| Anmerkungen: |
Date Completed 21.03.2023 Date Revised 31.03.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jpeds.2022.09.034 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM346973759 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM346973759 | ||
| 003 | DE-627 | ||
| 005 | 20231226032727.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jpeds.2022.09.034 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1156.xml |
| 035 | |a (DE-627)NLM346973759 | ||
| 035 | |a (NLM)36181872 | ||
| 035 | |a (PII)S0022-3476(22)00856-3 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Keefe, Gregory |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High Rate of Venous Thromboembolism in Severe Pediatric Intestinal Failure |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.03.2023 | ||
| 500 | |a Date Revised 31.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To quantify the rate of venous thromboembolism (VTE) in patients with pediatric intestinal failure and identify associated risk factors | ||
| 520 | |a STUDY DESIGN: We performed a retrospective cohort study in pediatric patients (<21 years old) with severe pediatric intestinal failure (≥90 consecutive days of parenteral nutrition) secondary to short bowel syndrome who were treated from 2014 to 2021 at an interdisciplinary intestinal rehabilitation program. The primary outcome was the incidence of VTE. Multivariable regression was performed to identify independent clinical predictors of VTE | ||
| 520 | |a RESULTS: A total of 263 patients (59.7% male) met the criteria for inclusion. The cumulative incidence of VTE was 28.1%, with a rate of 0.32 VTEs per 1000 catheter-days. On univariate analysis, the number of catheter days, number of catheters, and history of central line-associated blood stream infection were associated with VTE. On multivariable logistic regression, a higher number of catheters was an independent risk factor for VTE (aOR, 1.17; 95% CI, 1.06-1.29). Additionally, earlier gestational age was a risk factor for VTE such that every week decrease in gestational age conferred a 9% increased risk of VTE (aOR, 1.09; 95% CI, 1.02-1.16) | ||
| 520 | |a CONCLUSIONS: In this retrospective study, 28.1% of patients with severe pediatric intestinal failure developed VTE; the number of catheters and early gestational age were noted to be independent risk factors for VTE. This high incidence of VTE highlights the need to investigate VTE in pediatric intestinal failure prospectively, including the potential benefit of prophylactic anticoagulation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anticoagulation | |
| 650 | 4 | |a central venous catheter | |
| 650 | 4 | |a parenteral nutrition | |
| 650 | 4 | |a short bowel syndrome | |
| 650 | 4 | |a thrombosis | |
| 700 | 1 | |a Culbreath, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Staffa, Steven J |e verfasserin |4 aut | |
| 700 | 1 | |a Carey, Alexandra N |e verfasserin |4 aut | |
| 700 | 1 | |a Jaksic, Tom |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Riten |e verfasserin |4 aut | |
| 700 | 1 | |a Modi, Biren P |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of pediatrics |d 1945 |g 253(2023) vom: 21. Feb., Seite 152-157 |w (DE-627)NLM000019003 |x 1097-6833 |7 nnns |
| 773 | 1 | 8 | |g volume:253 |g year:2023 |g day:21 |g month:02 |g pages:152-157 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jpeds.2022.09.034 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 253 |j 2023 |b 21 |c 02 |h 152-157 | ||