[Risk factors and therapeutic management of deep venous thrombosis in hospitalized children]

Abstract

Objective: The incidence and treatment regimen for deep venous thrombosis (DVT) in hospitalized children in China are rarely reported. This report was to assess the incidence, risk factors and treatment strategy for deep venous thrombosis (DVT) among hospitalized children admitted to the First Affiliated Hospital, Sun Yat-sen University, a single tertiary-care hospital.

Methods: In twenty years between 1989 and 2009, 12 DVTs in hospitalized children (< 17 years old) were identified in this hospital. Clinical data were retrospectively reviewed.

Results: The incidence of DVT in hospitalized children was low, however, it demonstrated increasing trend from 0.52 per 10 000 admissions between 1989 and 1999 to 3.18 per 10 000 admissions between 2000 and 2009 in this hospital. Infection and trauma were the mostly frequent causes of DVT in hospitalized children. The catheter-related DVT was increasingly prevalent cause for DVT in hospitalized children. The other causes included nephritic syndrome, tumor, systemic lupus, and congenital plasma C protein deficiency. Two patients were complicated with pulmonary embolism. Only one neonate died due to kernicterus. Anticoagulation therapy was the first recommended treatment choice in hospitalized children with DVT, especially more low-molecular-weight heparin in recent 10 years. Antithrombotic treatment was used in 9 children older than 30 days through peripheral venous access, its application should be meticulously cautious in dosage. No bleeding occurred in all the patients.

Conclusions: Cautions should be given to DVT among hospitalized children due to its increasing incidence and special treatment pattern compared with adult patients.