Determination of risk factors for deep venous thrombosis in hospitalized children

Abstract

Purpose: Our objective was to determine the time trend and risk factors for deep venous thrombosis (DVT) of the lower extremities among pediatric inpatients.

Methods: This cross-sectional study used the data from the Health Care Cost and Utilization Project Kids' Inpatient Database for the years of 1997, 2000, and 2003 to estimate the DVT prevalence and crude and adjusted prevalence ratios. Patients between the ages of 1 and 17 years and who were hospitalized for at least 4 days were included.

Results: The weighted prevalence of DVT was 4.2 per 1000 hospital discharges (95% confidence interval [CI], 3.4-3.7). Independent of age, the prevalence of DVT was significantly greater in 2000 and 2003 compared to 1997, prevalence ratio (PR) of 1.2 and 1.4 (95% CI, 1.1-1.3 and 1.2-1.4). Using only the 2003 database, adjusted analysis revealed that patients at highest risk were those in the age range of 15 to 17 years (PR, 2.0; 95% CI, 1.6-2.4) and with the following comorbid conditions: obesity (PR, 2.1; 95% CI, 1.5-2.8), inflammatory bowel disease (PR, 1.8; 95% CI, 1.2-2.7), hematologic malignancy (PR, 2.5; 95% CI, 2.0-3.1), and thoracoabdominal (PR, 1.8; 95% CI, 1.6-2.2) or orthopedic (PR, 2.2; 95% CI, 1.7-2.8) operations. Predictors not associated with DVT included sex and diagnosis of trauma.

Conclusions: The discharge diagnosis of DVT of the lower extremities has significantly increased since 1997. In addition, teenagers with underlying disorders are at highest risk for DVT.