Risk of venous thromboembolism across the lifespan for individuals with cerebral palsy: A retrospective cohort study

Introduction

The risk of venous thromboembolism (VTE) for individuals with cerebral palsy (CP) is understudied. The objectives were to characterize the incidence of VTE by age and sex for individuals with CP compared with those without CP at the population- and clinical-levels.

Materials and methods

This retrospective cohort study used commercial claims from 1 January, 2011 to 31 December, 2017 from individuals of any age with and without CP. Sex-stratified incidence rate (IR) per 1000 person-years and IR ratio (IRR) of VTE were assessed across the lifespan up to 2-years of follow-up. The IR, IRR, and hazard ratio (HR using Cox regression) of VTE were assessed within 30-days following placement of a central venous catheter (CVC) (in one analysis) and orthopedic surgery (in another analysis).

Results

The 2-year IR of VTE for the full cohorts with (n = 20,486) and without (n = 22,161,726) CP was 19.1 and 9.7 for females (IRR = 1.97; 95%CI = 1.77–2.19) and 19.0 and 8.6 for males (IRR = 2.22; 95% CI = 2.01–2.45). The 30-day HR of VTE post-CVC (CP n = 1963; non-CP n = 558,150) was higher for adult males compared with those without CP (HR = 1.25 by 40 years to 1.80 by 80 years), but was not higher in pediatric males or females of any age compared with those without CP. The 30-day HR of VTE post-surgery (CP: n = 2634; non-CP: n = 1,066,136) was higher for pediatric patients and young adults compared with those without CP (HR = 2.58 to 2.79) There was no signficant difference between the groups among the older age groups.

Conclusions

The risk of VTE was elevated for individuals with CP across the lifespan, and some subgroups of CP had a greater 30-day risk of VTE following CVC placement and orthopedic surgery.