Incidence and risk factors for postthrombotic syndrome in neonates and children in a single-center cohort study.

IF 5.5 2区 医学 Q1 HEMATOLOGY Journal of Thrombosis and Haemostasis Pub Date : 2024-10-09 DOI:10.1016/j.jtha.2024.09.018
Irene Klaassen, Sahinde Sari, Heleen van Ommen, Eva Rettenbacher, Karin Fijnvandraat, Monique Suijker, Suzanne Cannegieter
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Abstract

Background: Postthrombotic syndrome (PTS) is a chronic condition following deep vein thrombosis (DVT) and is associated with pain, swelling, and restricted use of the affected limb. In pediatric age groups, its incidence and risk factors are not well-known.

Methods: This observational cohort study of all consecutive children (≤18 years) with DVT treated at the Emma Children's Hospital Amsterdam between January 2001 and January 2021 was conducted to identify incidence and risk factors for PTS in neonates aged ≤2 months and children aged >2 months. PTS was diagnosed using the modified Villalta scale.

Results: In total, 315 patients were included. The 20-year incidence of PTS was 20.0% in neonates and 40.0% in children. In neonates, involvement of ≥3 vessels (odds ratio [OR], 6.6; 95% CI, 1.6-26.4) and incomplete thrombus resolution (OR, 3.0; 95% CI, 1.1-8.0) were risk factors for PTS. In children, involvement of ≥3 vessels (OR, 6.2; 95% CI, 2.2-17.8), recurrent DVT (OR, 3.7; 95% CI, 1.3-10.3), and incomplete thrombus resolution (OR, 5.2; 95% CI, 1.6-17.0) were associated with PTS. Exercise ≥3 times/wk (OR, 0.4; 95% CI, 0.2-0.9), central venous catheter-related DVT (OR, 0.2; 95% CI, 0.1-0.5), and provoked DVT (OR, 0.4; 95% CI, 0.1-0.97) were protective factors for PTS.

Conclusion: This study demonstrated a high incidence of pediatric PTS. Additionally, risk factors for PTS differed between neonates and children. These findings provide a basis for better prevention and management of PTS that may differ between neonates and children.

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单中心队列研究中新生儿和儿童血栓后综合征的发病率和风险因素。
血栓后综合征(PTS)是深静脉血栓形成(DVT)后的一种慢性疾病,与疼痛、肿胀和患肢使用受限有关。在儿童年龄组中,其发病率和风险因素尚不为人所知。这项观察性队列研究对 2001 年 1 月至 2021 年 1 月期间在阿姆斯特丹艾玛儿童医院接受治疗的所有连续深静脉血栓患儿(18 岁以下)进行了研究,以确定 2 个月以下新生儿和 2 个月以上儿童的 PTS 发病率和风险因素。PTS 采用改良维拉尔塔量表进行诊断。共纳入 315 名患者。20 年来,新生儿 PTS 的发病率为 20.0%,儿童为 40.0%。在新生儿中,累及≥3条血管(OR 6.6;95% CI 1.6-26.4)和血栓未完全溶解(OR 3.0;95% CI 1.1-8.0)是PTS的危险因素。在儿童中,累及≥ 3 根血管(OR 6.2,95% CI 2.2-17.8)、复发性深静脉血栓(OR 3.7,95% CI 1.3-10.3)和血栓未完全溶解(OR 5.2,95% CI 1.6-17.0)与 PTS 相关。运动≥3次/周(OR 0.4;95% CI 0.2-0.9)、中心静脉导管相关深静脉血栓(OR 0.2,95% CI 0.1-0.5)和诱发深静脉血栓(OR 0.4,95% CI 0.1-0.97)是PTS的保护因素。这项研究表明,儿科 PTS 的发病率很高。此外,新生儿和儿童的 PTS 风险因素也有所不同。这些发现为更好地预防和管理新生儿和儿童之间可能存在差异的 PTS 提供了依据。
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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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