Venous Thromboembolism in Children and Teenagers Admitted for Trauma: A 5-Year Nationwide Perspective.

Jennifer Hernandez, Luis A. Quintero, Zaineb Shatawi, Lisa Ngo, Dino Romero, Rainya Heath, Anna Redden, Tamar Levene, Oliver B Lao, Joshua P Parreco
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Abstract

Venous thromboembolism (VTE) in pediatric trauma patients is under-investigated. The purpose of this study was to perform an evaluation of the risk factors for VTE after pediatric trauma, including readmissions across the United States. The Nationwide Readmissions Database for 2016-2020 was queried for all patients under the age of 18 years admitted for trauma. 276 670 patients were identified; 2063 (.8%) were diagnosed with VTE. Among those with VTE, 300 (15%) were identified during a readmission. Higher rates of VTE were seen in ages 15-17 years (n = 1,294, 1.3%, P < .001), penetrating injuries (n = 478, .9%, P < .001), and assault (n = 271, 2.7%, P < .001). The strongest risk factor for VTE was prolonged mechanical ventilation (OR 5.5 [4.9-6.3] P < .001). Our study found that a significant portion of post-traumatic VTE in children and teenagers occur during readmissions. A deeper understanding of the risk factors outlined here can guide enhanced clinical protocols, ensuring early detection and prevention of this complication.
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因外伤入院的儿童和青少年静脉血栓栓塞症:5 年全国范围内的透视。
对小儿创伤患者静脉血栓栓塞症(VTE)的调查不足。本研究旨在评估儿科创伤后 VTE 的风险因素,包括美国各地的再入院情况。研究人员查询了 2016-2020 年全国再入院数据库中所有因外伤入院的 18 岁以下患者。共发现 276 670 名患者,其中 2063 人(0.8%)被诊断为 VTE。在 VTE 患者中,有 300 人(15%)是在再次入院时被确诊的。15-17岁(n = 1,294, 1.3%, P < .001)、穿透性损伤(n = 478, .9%, P < .001)和袭击(n = 271, 2.7%, P < .001)的 VTE 发生率较高。VTE的最强风险因素是长期机械通气(OR 5.5 [4.9-6.3] P < .001)。我们的研究发现,很大一部分儿童和青少年创伤后 VTE 发生在再次入院期间。深入了解本文概述的风险因素可以指导临床方案的改进,确保及早发现和预防这种并发症。
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