Pediatric venous thromboembolism: incidence and patient profile in a single Brazilian institution.

Liana Ariel de Siqueira Lira, Jorge David Aivazoglou Carneiro, Maria do Carmo Menezes Bezerra Duarte
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Abstract

Background: As the diagnosis of Pediatric venous thromboembolism has dramatically increased in recent decades, this study aims to evaluate these patients, determining the incidence and describing their biological and clinical characteristics.

Methods: An observational, cross-sectional study was conducted at a Brazilian quaternary hospital between January 2022 and February 2023. Under 18-year-old hospitalized patients with a confirmed diagnosis of venous thromboembolism were included, while those with arterial or chronic thrombosis were excluded. Data on biological and clinical characteristics, diagnosis and treatment were evaluated. A descriptive data analysis was performed and the incidence of hospital-associated thrombosis was calculated.

Results: Thirty-nine pediatric patients were evaluated. The incidence of hospital-associated thrombosis was 19.9 cases per 10,000 pediatric hospitalizations. Median age at diagnosis was four months (range: 12 days-17 years). Most of the patients (66.7%) were asymptomatic, with venous thromboembolism being diagnosed incidentally. In all cases, at least one risk factor was identified and in 74.6% of cases four or more factors were present. The principal risk factors were the presence of a central venous catheter (89.7%) and infection (89.7%). Thrombogenic comorbidities, particularly congenital heart disease, were present in 48.7% of patients.

Conclusions: The incidence of venous thromboembolism found in the present study was lower than rates reported in developed countries. The principal characteristics of this sample were a greater frequency of central venous catheter and infection as risk factors, and the fact that the cases consisted mainly of newborns and individuals with heart disease.

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小儿静脉血栓栓塞症:巴西一家医疗机构的发病率和患者概况。
背景:近几十年来,小儿静脉血栓栓塞症的诊断率急剧上升:近几十年来,小儿静脉血栓栓塞症的诊断率急剧上升,本研究旨在对这些患者进行评估,确定其发病率并描述其生物和临床特征:方法:2022 年 1 月至 2023 年 2 月期间,在巴西一家四级医院进行了一项横断面观察研究。研究对象包括确诊为静脉血栓栓塞症的 18 岁以下住院患者,但不包括动脉血栓或慢性血栓患者。对生物和临床特征、诊断和治疗数据进行了评估。对数据进行了描述性分析,并计算了医院相关血栓形成的发生率:结果:共评估了 39 名儿科患者。结果:共对 39 名儿科患者进行了评估,医院相关血栓症的发病率为每万名住院儿科患者中有 19.9 例。确诊时的中位年龄为 4 个月(范围:12 天-17 岁)。大多数患者(66.7%)没有症状,静脉血栓栓塞症是偶然诊断出来的。在所有病例中,至少发现了一个风险因素,74.6%的病例存在四个或四个以上的风险因素。主要风险因素是中心静脉导管(89.7%)和感染(89.7%)。48.7%的患者存在血栓形成合并症,尤其是先天性心脏病:结论:本研究发现的静脉血栓栓塞症发病率低于发达国家报告的发病率。该样本的主要特点是,中心静脉导管和感染是更常见的风险因素,而且病例主要由新生儿和心脏病患者组成。
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