Evaluation of venous thromboembolism risk factors reveals subtype heterogenicity in children with central venous catheters: a multicenter study from the Children's Hospital Acquired Thrombosis consortium.

Autor:	Jaffray J; Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California, USA; Division of Hematology/Oncology, Rady Children's Hospital, San Diego, California, USA. Electronic address: jjaffray@rchsd.org., Mosha M; Data Coordinating Center, Johns Hopkins All Children's Institute for Clinical and Translational Research, St. Petersburg, Florida, USA., Branchford B; Versiti Medical Sciences Institute, Milwaukee, Wisconsin, USA; Division of Hematology/Oncology, Children's Wisconsin Hospital, Milwaukee, Wisconsin, USA., Goldenberg NA; Data Coordinating Center, Johns Hopkins All Children's Institute for Clinical and Translational Research, St. Petersburg, Florida, USA; Departments of Pediatrics and Medicine, Hopkins University School of Medicine, Baltimore, Maryland, USA., Silvey M; Division of Hematology/Oncology, Children's Mercy Hospital, Kansas City, Missouri, USA., Croteau SE; Division of Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA., Fargo JH; Division of Hematology/Oncology, Akron Children's Hospital, Akron, Ohio, USA., Cooper JD; Division of Hematology/Oncology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA., Bakeer N; Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA., Stillings A; Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California, USA., Krava E; Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California, USA., Young G; Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California, USA; Division of Hematology/Oncology, Rady Children's Hospital, San Diego, California, USA., Amankwah EK; Data Coordinating Center, Johns Hopkins All Children's Institute for Clinical and Translational Research, St. Petersburg, Florida, USA; Departments of Oncology and Pediatrics, Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2023 Sep; Vol. 21 (9), pp. 2441-2450. Date of Electronic Publication: 2023 Apr 25.
DOI:	10.1016/j.jtha.2023.03.045
Abstrakt:	Background: Acutely ill and medically complex children frequently rely on central venous catheters (CVCs) to provide life-sustaining treatment. Unfortunately, catheter-related thrombosis (CRT) is a serious and common complication. Little is known why some with a CVC develop CRT and others develop venous thromboembolism unrelated to the CVC (non-CRT). Objectives: The aim of this study was to identify factors associated with CRT in children with hospital-acquired venous thromboembolism (HA-VTE). Methods: This case-case study included participants in the Children's Hospital Acquired Thrombosis Registry with HA-VTE and CVC aged 0 to 21 years from 8 US children's hospitals. Participants were excluded if they developed HA-VTE prior to CVC insertion or if the CVC insertion date was unknown. Logistic regression models were used to assess associations between clinical factors and CRT status. Results: There were 1144 participants with HA-VTE who had a CVC. CRT developed in 833 participants, and 311 developed non-CRT. Multivariable analysis showed increased odds of CRT (compared with non-CRT) in participants with peripherally inserted central catheters (odds ratio [OR], 3.80; 95% CI, 2.04-7.10; p < .001), CVCs inserted in the femoral vein (OR, 4.45; 95% CI, 1.70-11.65; p = .002), multiple CVCs (OR, 1.42; 95% CI, 1.18-1.71; p < .001), and CVC malfunction (OR, 3.30; 95% CI, 1.80-6.03; p < .001). Conclusion: The findings of this study provide new insights on risk factor differences between CRT and non-CRT. Prevention efforts should be directed at modifying the type of CVC, insertion location, and/or number of CVCs placed, if possible, to decrease the incidence of CRT. Competing Interests: Declaration of competing interests There are no competing interests to disclose. (Copyright © 2023 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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