Venous thromboembolism risk factors in a pediatric trauma population

2018 ◽  
Vol 35 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Louis A. Carrillo ◽  
Akshita Kumar ◽  
Matthew T. Harting ◽  
Claudia Pedroza ◽  
Charles S. Cox
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Pediatric Trauma ◽  
Trauma Population

Trauma-Induced Coagulopathy in Children

2020 ◽  
Vol 46 (02) ◽  
pp. 147-154 ◽  
Author(s):  
Amelia C. Lucisano ◽  
Christine M. Leeper ◽  
Barbara A. Gaines
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Pediatric Trauma ◽  
Risk Groups ◽  
Trauma Patients ◽  
Trauma Induced Coagulopathy ◽  
Pediatric Resuscitation ◽  
Key Aspects

AbstractTrauma-induced coagulopathy (TIC) is well documented in injured children. However, many important features of pediatric hemostasis are still in development in early childhood and may impact TIC. Certain pediatric subgroups are at a higher risk. Traumatic brain injury, which occurs with a higher rate in children, and physical child abuse are known risk factors for TIC that deserve special consideration. Resuscitation of a pediatric trauma patient follows many of the same goals as in the injured adult trauma, although some key aspects of pediatric resuscitation require ongoing investigation. Venous thromboembolism occurs with higher rates in certain high-risk groups of pediatric trauma patients, although overall it is considerably less frequent in children as compared with adults.

Venous thromboembolism prophylaxis in the pediatric trauma population

2013 ◽  
Vol 48 (6) ◽  
pp. 1413-1421 ◽  
Author(s):  
A. Jill Thompson ◽  
S. David McSwain ◽  
Sally A. Webb ◽  
Melanie A. Stroud ◽  
Christian J. Streck
Keyword(s):  
Venous Thromboembolism ◽  
Pediatric Trauma ◽  
Thromboembolism Prophylaxis ◽  
Venous Thromboembolism Prophylaxis ◽  
Trauma Population

scholarly journals Ventilator Associated Pneumonia in Pediatric Trauma Patients

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Dalton Sullivan ◽  
Matthew P. Landman ◽  
Rachel E. Gahagen Gahagen
Keyword(s):  
Risk Factors ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Hospital Acquired Infection ◽  
Trauma Population ◽  
Hospital Acquired ◽  
Cultured Bacteria ◽  
The Impact ◽  
Overall Mortality

Background: Ventilator associated pneumonia (VAP) is a common hospital-acquired infection found in intubated trauma patients. In previous adult studies, VAP has been associated with an increase in length of stay, cost, morbidity, mortality, and longer mechanical ventilation. There remains little examination of the risk factors, prognosis, and microbiology of VAP within the pediatric trauma population. This study aims to analyze factors associated with VAP in pediatric trauma patients. Methods: The Riley Hospital for Children Trauma Registry was utilized to identify intubated pediatric trauma patients from 2016-2020. Patients were excluded if intubated for less than 48 hours.   VAP was defined as positive if patients met either Centers for Disease Control definition and or were clinically diagnosed with and treated for VAP. Univariate and multivariate modeling was performed. Results: A total of 171 patients met inclusion criteria and 43 (25%) were diagnosed with VAP. The median age was 8 years (2-13) and ISS was 26.5 (22-35). The median duration of intubation was 203.8 hours (117.3-331.3). The overall mortality was 55 (32.2%). While variables such as lower age and use of MTP resulted in a higher likelihood of mortality, VAP diagnosis was not associated with increased mortality. BAL analysis displayed that the most common cultured bacteria were H. influenzae, Staph. aureus, and Strep. Pneumoniae with most VAPs being diagnosed on day 2 of admission. When analyzing the impact of age, ISS, intubation hours, ICU days, and GI prophylaxis on VAP, only age was significantly associated with VAP: for each year the odds of VAP rose by 10%. Conclusions: A quarter of the pediatric trauma patients were diagnosed with VAP during the study period.  No modifiable risk factors were found for VAP with only patient age demonstrating significance for the diagnosis.  Further investigation into VAP definition and prevention in pediatric trauma patients should occur given it’s prevalence.

Risk Factors for Venous Thromboembolism in Pediatric Trauma

2002 ◽  
Vol 52 (5) ◽  
pp. 922-927 ◽  
Author(s):  
Monica S. Vavilala ◽  
Avery B. Nathens ◽  
Gregory J. Jurkovich ◽  
Ellen Mackenzie ◽  
Frederick P. Rivara
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Pediatric Trauma

scholarly journals Risk factors for venous thromboembolism after pediatric trauma

2016 ◽  
Vol 51 (1) ◽  
pp. 168-171 ◽  
Author(s):  
Casey J. Allen ◽  
Clark R. Murray ◽  
Jonathan P. Meizoso ◽  
Juliet J. Ray ◽  
Holly L. Neville ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Pediatric Trauma

scholarly journals Risk Factors for Venous Thromboembolism in Pediatric Trauma Patients and Validation of a Novel Scoring System

2016 ◽  
Vol 17 (5) ◽  
pp. 391-399 ◽  
Author(s):  
Jennifer Yen ◽  
Kyle J. Van Arendonk ◽  
Michael B. Streiff ◽  
LeAnn McNamara ◽  
F. Dylan Stewart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Scoring System ◽  
Pediatric Trauma ◽  
Trauma Patients

Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

1990 ◽  
Vol 63 (01) ◽  
pp. 013-015 ◽  
Author(s):  
E J Johnson ◽  
C R M Prentice ◽  
L A Parapia
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Potential Risk ◽  
Antithrombin Iii ◽  
Arterial Disease ◽  
Coagulation System ◽  
Early Age ◽  
Arterial Thromboembolism ◽  
Potential Risk Factors ◽  
Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

Risk Factors for Bleeding during Treatment of Acute Venous Thromboembolism

1996 ◽  
Vol 76 (05) ◽  
pp. 682-688 ◽  
Author(s):  
Jos P J Wester ◽  
Harold W de Valk ◽  
Karel H Nieuwenhuis ◽  
Catherine B Brouwer ◽  
Yolanda van der Graaf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Small Body ◽  
Bleeding Risk ◽  
Risk Scores ◽  
Risk Of Bleeding ◽  
Acute Venous Thromboembolism

Summary Objective: Identification of risk factors for bleeding and prospective evaluation of two bleeding risk scores in the treatment of acute venous thromboembolism. Design: Secondary analysis of a prospective, randomized, assessor-blind, multicenter clinical trial. Setting: One university and 2 regional teaching hospitals. Patients: 188 patients treated with heparin or danaparoid for acute venous thromboembolism. Measurements: The presenting clinical features, the doses of the drugs, and the anticoagulant responses were analyzed using univariate and multivariate logistic regression analysis in order to evaluate prognostic factors for bleeding. In addition, the recently developed Utrecht bleeding risk score and Landefeld bleeding risk index were evaluated prospectively. Results: Major bleeding occurred in 4 patients (2.1%) and minor bleeding in 101 patients (53.7%). For all (major and minor combined) bleeding, body surface area ≤2 m2 (odds ratio 2.3, 95% Cl 1.2-4.4; p = 0.01), and malignancy (odds ratio 2.4, 95% Cl 1.1-4.9; p = 0.02) were confirmed to be independent risk factors. An increased treatment-related risk of bleeding was observed in patients treated with high doses of heparin, independent of the concomitant activated partial thromboplastin time ratios. Both bleeding risk scores had low diagnostic value for bleeding in this sample of mainly minor bleeders. Conclusions: A small body surface area and malignancy were associated with a higher frequency of bleeding. The bleeding risk scores merely offer the clinician a general estimation of the risk of bleeding. In patients with a small body surface area or in patients with malignancy, it may be of interest to study whether limited dose reduction of the anticoagulant drug may cause less bleeding without affecting efficacy.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

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