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Venous thromboembolic disease: A single‐centre case series study
Author(s) -
Newall Fiona,
Wallace Tim,
Crock Catherine,
Campbell Janine,
Savoia Helen,
Barnes Chris,
Monagle Paul
Publication year - 2006
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2006.00981.x
Subject(s) - medicine , venous thrombosis , epidemiology , thrombosis , prospective cohort study , etiology , incidence (geometry) , pediatrics , thrombus , surgery , physics , optics
Aim: The epidemiology of venous thromboembolism in children has likely changed since first being described a decade ago because of evolving management strategies and a greater awareness of predisposing factors for thrombosis in children. The Royal Children's Hospital commenced a 4‐year prospective registry of venous thrombosis in 1999 to determine the current Australian epidemiology of venous thrombosis in infants and children. Methods: A prospective, single‐centre registry was established to determine the prevalence, aetiology, diagnostic criteria, management and outcome of venous thromboembolism in an Australian tertiary paediatric centre. Results: The incidence of venous thrombosis was 8.0/10 000 hospital admissions. Fifty‐eight per cent of infants and 49% of children were male. Seventy‐seven per cent of venous thromboses in infants were associated with central venous cannulation compared with 47% in children. Doppler ultrasonography was the most frequently used diagnostic tool. Treatment strategies varied between age groups. The all‐cause mortality rate for infants and children in this study was 8.4% (direct thrombus‐related mortality 0%). Fifteen per cent of all patients demonstrated complete resolution of their venous thrombosis at discharge, with 48% demonstrating complete resolution at follow‐up assessment. Fifteen per cent of patients experienced significant thrombosis‐related morbidity at follow‐up assessment. Conclusion: In this single‐centre registry, venous thrombosis in infants and children occurred with greater frequency than has previously been reported and its epidemiology varied. Central venous catheterisation continues to be a common precipitant to venous thrombosis. Optimal diagnostic and treatment interventions for venous thromboembolism have not yet been determined for infants and children, despite the significant incidence of long‐term sequelae.