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Risk factors for hospital acquired venous thromboembolism in congenital heart disease patients: A report from the children's hospital acquired thrombosis (CHAT) consortium

  • Michael Silvey
    Correspondence
    Corresponding author at: Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64081, United States of America.
    Affiliations
    Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, United States of America
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  • Anh Thy H. Nguyen
    Affiliations
    Data Coordinating Center for Pediatric Multicenter Studies, Institute for Clinical and Translational Science, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States of America
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  • Ernest K. Amankwah
    Affiliations
    Data Coordinating Center for Pediatric Multicenter Studies, Institute for Clinical and Translational Science, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States of America

    Departments of Oncology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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  • Emily McElwaine
    Affiliations
    Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, United States of America
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  • Brian Branchford
    Affiliations
    Versiti Medical Sciences Institute and Dept of Pediatrics, Division of Hematology/Oncology, Medical College of Wisconsin, Wauwatosa, WI, United States of America
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  • Amy Stillings
    Affiliations
    Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States of America
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  • Emily Krava
    Affiliations
    Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States of America
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  • Guy Young
    Affiliations
    Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States of America

    Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, CA, United States of America
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  • Neil Goldenberg
    Affiliations
    Data Coordinating Center for Pediatric Multicenter Studies, Institute for Clinical and Translational Science, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States of America

    Departments of Medicine and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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  • Julie Jaffray
    Affiliations
    Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States of America

    Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, CA, United States of America
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      Abstract

      Introduction

      The incidence of pediatric hospital-acquired venous thromboembolism (HA-VTE) has increased over time. Congenital heart disease (CHD) as a co-morbidity has been demonstrated to significantly increase HA-VTE risk among hospitalized children.

      Objective

      To identify specific risks factors for the development of HA-VTE in hospitalized children with CHD.

      Materials and methods

      This retrospective case-control study included hospitalized participants aged 0–21 years within the Children's Hospital Acquired Thrombosis (CHAT) Consortium Registry with a co-morbidity of CHD. Participants with HA-VTE and non-VTE controls with a past medical history of CHD were selected from the CHAT Registry and data regarding multiple clinical variables were extracted. These variables were then analyzed to assess their association with HA-VTE development.

      Results

      Three hundred and thirty-three participants with a co-morbidity of CHD were identified, comprising 275 HA-VTE cases and 58 controls. Median age for HA-VTE cases was 0.4 (IQR = 0–2.6) years compared to 3.4 (IQR = 0.7–6.5) for controls. Male participants were predominant in both groups (57.5 % HA-VTE cases vs 51.7 % controls). Multivariable analysis identified prior recent hospitalization (OR = 4.12, 95%CI = 1.66–10.24), intensive care unit (ICU) admission (OR = 3.29, 95 % CI = 1.15–9.40), and CVC placement (OR = 9.14, 95 % CI = 3.38–24.72) as significant risk factors for HA-VTE in subjects with CHD.

      Conclusions

      ICU admission, CVC placement, and prior hospitalization were identified as statistically significant predictors associated with HA-VTE development in hospitalized children with history of CHD. Prospective studies are needed to validate these results and help develop strategies to mitigate HA-VTE development in these patients.

      Keywords

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