Clinical presentation and therapeutic management of venous thrombosis in young children: a retrospective analysis
Autor: | Dolores Elorza, Guy Young, Gili Kenet, Damien Bonnet, Paul Monagle, Sebastian Grunt, Eva Hurst, Jeroen van Kesteren, Dagmar Kubitza, Amy Mason, Ivet Adalbo, Marta Ybarra, Kirstin Thelen, Anthonie W. A. Lensing, Tina Biss, Amparo Santamaría, Francesco Climent, Joseph Palumbo, Philip Connor, William T. Smith, Scott D. Berkowitz, Grahaem Brown, Jacqueline Halton, Paola Saracco, Anthony K.C. Chan |
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Rok vydání: | 2018 |
Předmět: |
Pediatrics
medicine.medical_specialty Registry 610 Medicine & health 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Anticoagulation 0302 clinical medicine Randomized controlled trial Rivaroxaban law Internal medicine medicine Venous thromboembolism (VTE) 030212 general & internal medicine cardiovascular diseases Angiology Pediatric trial Hematology lcsh:RC633-647.5 business.industry Research Direct oral anticoagulant (DOAC/NOAC) lcsh:Diseases of the blood and blood-forming organs medicine.disease equipment and supplies Thrombosis Discontinuation stomatognathic diseases Venous thrombosis Presentation (obstetrics) business medicine.drug |
Zdroj: | Thrombosis Journal r-FISABIO. Repositorio Institucional de Producción Científica instname Chan, Anthony; Lensing, Anthonie W A; Kubitza, Dagmar; Brown, Grahaem; Elorza, Dolores; Ybarra, Marta; Halton, Jacqueline; Grunt, Sebastian; Kenet, Gili; Bonnet, Damien; Santamaria, Amparo; Saracco, Paola; Biss, Tina; Climent, Francesco; Connor, Philip; Palumbo, Joseph; Thelen, Kirstin; Smith, William T; Mason, Amy; Adalbo, Ivet; ... (2018). Clinical presentation and therapeutic management of venous thrombosis in young children: a retrospective analysis. Thrombosis journal, 16(29), p. 29. BioMed Central 10.1186/s12959-018-0182-4 Thrombosis Journal, Vol 16, Iss 1, Pp 1-9 (2018) Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
ISSN: | 1477-9560 |
Popis: | Background: Venous thromboembolism (VTE) in young children is not well documented. Methods: Clinicians from 12 institutions retrospectively evaluated the presentation, therapeutic management, and outcome of VTE in children younger than 2 years seen in 2011-2016. Feasibility of recruiting these children in EINSTEIN-Jr. phase III, a randomized trial evaluating rivaroxaban versus standard anticoagulation for VTE, was assessed. Results: We identified 346 children with VTE, of whom 227 (65.6%) had central venous catheter-related thrombosis (CVC-VTE), 119 (34.4%) had non-CVC-VTE, and 156 (45.1%) were younger than 1 month. Of the 309 children who received anticoagulant therapy, 86 (27.8%) had a short duration of therapy (i.e. < 6 weeks for CVC-VTE and < 3 months for non-CVC-VTE) and 17 (5.5%) had recurrent VTE during anticoagulation (n = 8, 2.6%) or shortly after its discontinuation (n = 9, 2.9%). A total of 37 (10.7%) children did not receive anticoagulant therapy and 4 (10.5%) had recurrent VTE. The average number of children aged < 0.5 years and 0.5-2 years who would have been considered for enrolment in EINSTEIN-Jr is approximately 1.0 and 0.9 per year per site, respectively. Conclusions: Young children with VTE most commonly have CVC-VTE and approximately one-tenth and one-fourth received no or only short durations of anticoagulant therapy, respectively. Recurrent VTE rates without anticoagulation, during anticoagulation or shortly after its discontinuation seem comparable to those observed in adults. Short and flexible treatment durations could potentially increase recruitment in EINSTEIN-Jr. phase III. |
Databáze: | OpenAIRE |
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