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Central venous catheters are an important factor in paediatric thrombosis
Author(s) -
Biswas Mouri,
Ryan Paul M.,
Nakrani Rima,
Bhatt Mihir,
Chan Anthony K. C.,
Mondal Tapas
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15543
Subject(s) - medicine , thrombosis , incidence (geometry) , pulmonary embolism , venous thrombosis , low molecular weight heparin , stroke (engine) , risk factor , malignancy , retrospective cohort study , pediatrics , surgery , mechanical engineering , physics , optics , engineering
Aim To establish the incidence and characteristics of paediatric thrombosis (PT) in a Canadian tertiary care centre during the era of low molecular weight heparin (LMWH). Methods A retrospective observational case study of all patients <18 years of age evaluated for arterial and venous thrombosis from May 2008 to July 2018 at McMaster Children’s Hospital was conducted through the electronic medical record. Results The incidence of PT was 52.2 per 10 000 hospital admissions (n = 477/91 462). Provoked thrombosis was more prevalent (88.9%, n = 424/477) than unprovoked (2.9%, n = 14/477) or idiopathic thrombosis (4%, n = 19/477). Half of PT were in children <2 years (51.2%, n = 244/477). Central vascular catheterisation was a contributory factor in more than half of thrombotic events (56.2%, n = 268/477), while trauma (1.1%, n = 5/477), oral contraceptives (4%, n = 19/477), infection (4%, n = 19/477), surgery (6.9%, n = 33/477) and malignancy (8.4%, n = 40/477) were also risk factors. Arterial ischaemic stroke was diagnosed in 11.1% of cases (n = 53/477), while pulmonary embolism was identified in 7.1% (n = 34/477) and 1.7% of cases were fatal (n = 8/477). LMWH was the first‐line therapeutic of choice (47.8%, n = 228/477), with 28.1% (n = 134/477) requiring no intervention. Conclusion These data reiterate the elevated thrombosis risk to which infants and children with central vascular access are exposed.