Systemic thromboembolism in children

Stefan Kuhle; Patricia Massicotte; Anthony Chan; Margaret Adams; Mohamed Abdolell; Gabrielle de Veber; Lesley Mitchell

doi:10.1160/TH04-04-0207

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 92(04): 722-728
DOI: 10.1160/TH04-04-0207

Theme Issue Article

Schattauer GmbH

Systemic thromboembolism in children

Data from the 1-800-NO-CLOTS Consultation Service

Stefan Kuhle

¹Department of Population Health Sciences, The Hospital for Sick Children, Toronto, Canada

²Department of Neonatology, University Children’s Hospital, Tübingen, Germany

,

Patricia Massicotte

³Division of Haematology and Oncology, The Hospital for Sick Children, Toronto, Canada

,

Anthony Chan

⁴Department of Pediatrics, McMaster University, Hamilton, Canada

,

Margaret Adams

¹Department of Population Health Sciences, The Hospital for Sick Children, Toronto, Canada

,

Mohamed Abdolell

⁵Cancer Quality Council of Ontario Secretariat, Cancer Care Ontario, Toronto, Canada

⁶Department of Public Health Sciences, University of Toronto, Canada

,

Gabrielle de Veber

¹Department of Population Health Sciences, The Hospital for Sick Children, Toronto, Canada

,

Lesley Mitchell

¹Department of Population Health Sciences, The Hospital for Sick Children, Toronto, Canada

⁶Department of Public Health Sciences, University of Toronto, Canada

› Author Affiliations

Abstract

Summary

Thromboembolism (TE) has recently been recognized as a clinical entity in children. Determining the clinical characteristics of pediatric TE is an important first step in dealing with this new disorder. The paper summarizes 1776 consecutive children with systemic TE referred to 1-800-NO-CLOTS telephone consultation service. 1-800-NO-CLOTS is a free consultation service for clinicians managing pediatric TE. Patient information was collected immediately using standardized forms. In children with systemic TE, infants under one year of age (47%) including neonates (26%) represented the largest distinct pediatric age group. Age-related differences were seen in TE locations, associated conditions, and risk factors. However, venous TE was the most frequent manifestation (74%). Neonates and children with cardiac disorders were more likely to have an arterial TE than a venous TE Beyond the neonatal period, venous TE associated with a central line is more likely to occur than arterial TE. Children with ALL were 5.7 times more likely to have a venous TE than an arterial TE. TE were infrequent in otherwise healthy children with 90% of children having at least one risk factor. Central catheters were the single most common risk factor associated with TE, present in 2/3 of children. Ultrasound was most frequently employed for diagnosis of TE. Finally, there was marked heterogeneity in treatment of children with TE. In children, neonates form the largest single group with TE. TE usually occur only in the presence of one or more risk factors with catheters being the single most important factor.

Keywords

Children - thromboembolism - diagnosis - treatment - epidemiology

Full Text

References

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