The Continued Rise of Venous Thromboembolism Across US Children's Hospitals.

Autor:	O'Brien SH; Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio.; Center for Health Equity and Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio., Stanek JR; Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio.; Biostatistics Resource at Nationwide Children's Hospital, Columbus, Ohio., Witmer CM; Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Raffini L; Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2022 Mar 01; Vol. 149 (3).
DOI:	10.1542/peds.2021-054649
Abstrakt:	Objectives: In 2009, a large multicenter study demonstrated that the rate of pediatric venous thromboembolism (VTE) across US children's hospitals had significantly increased from 2001 to 2007. The objective of this study was to evaluate the rate of pediatric VTE from 2008 to 2019 using similar methodology. Methods: A retrospective cohort study using the Pediatric Health Information System (PHIS) database. Subjects from birth to <18 years admitted from 2008 through 2019 who had an ICD-9-CM or ICD-10-CM code for VTE were included. Demographics, underling medical comorbidities and mortality were collected. VTE location and anticoagulation data during admission were extracted. Results: During the 12-year study period, there were 52 401 hospital admissions among 39 713 pediatric patients with a diagnosis of VTE. The VTE admission rate increased from 46 VTE cases per 10 000 admissions in 2008 to 106 VTE cases per 10 000 admissions in 2019, a 130% increase (P < .0001) in VTE events. The median age at admission was 6.1 years, and almost one-third (31.3%) of patients with VTE were in the adolescent age group (13-17 years). Most patients (78%) had an underlying chronic medical condition. Conclusions: The rate of VTE in hospitalized pediatric patients continues to increase from a 70% increase reported from 2001 to 2007 to the 130% increase from 2008 to 2019. These findings support the need for more effective VTE prevention strategies. Clinical trials focused on risk stratification and VTE prevention are needed. Competing Interests: CONFLICT OF INTEREST DISCLOSURES: Dr O’Brien serves on the steering committee/advisory boards for 2 clinical trials of apixaban in pediatric thrombosis (Bristol Myers Squibb, Pfizer). The remaining authors have nothing to disclose. (Copyright © 2022 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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