Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Oct;18(10):2601-2612.
doi: 10.1111/jth.14984. Epub 2020 Aug 26.

Predictors of postthrombotic syndrome in pediatric thrombosis: A systematic review and meta-analysis of the literature

Elissa R Engel  1 , Anh Thy H Nguyen  2 , Ernest K Amankwah  2   3   4 , Manuela Albisetti  5 , Leonardo R Brandão  6 , Neil A Goldenberg  4   7   8 , Marisol Betensky  7   9
Affiliations
Free article
Meta-Analysis

Predictors of postthrombotic syndrome in pediatric thrombosis: A systematic review and meta-analysis of the literature

Elissa R Engel et al. J Thromb Haemost. 2020 Oct.
Free article

Abstract

Background: Postthrombotic syndrome (PTS) is a significant complication of pediatric deep venous thrombosis (DVT). There is a gap in the understanding of the risk factors associated with the development of pediatric PTS preventing the early identification of those patients at greatest risk, and the development of risk-stratified interventions.

Objectives: To conduct a systematic review and meta-analysis of the literature on prognostic factors for PTS development in pediatric patients.

Methods: A systematic search of MEDLINE, EMBASE, and the Cochrane Library from 1960 to December 2018 was performed. Eligible studies reported at least one prognostic factor for PTS development in patients < 21 years of age with a radiographically confirmed DVT. To be included in the meta-analysis, prognostic factors had to be reported in at least three published studies.

Results and conclusions: Twelve studies (n = 1160 patients) met criteria for inclusion. Ninety-three percent of patients with an extremity DVT (n = 1076) were assessed for PTS. PTS developed in 40% (n = 434) of these patients. Central venous catheter-associated DVT (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.08-2.98), complete veno-occlusion (OR, 1.89; 95% CI, 1.04-3.46), and incomplete DVT resolution (OR, 2.07; 95% CI, 1.4-3.07) were identified as candidate prognostic factors for pediatric PTS. These findings should be interpreted in the context of the heterogeneity of the included studies and the limitations of current pediatric PTS assessment tools. Further, the predictive value of these prognostic factors will need to be validated in future collaborative prospective multicenter studies that maximize the homogeneity of pediatric DVT patients.

Keywords: VTE complications; pediatrics; post-thrombotic syndrome; venous thromboembolism.

PubMed Disclaimer

References

REFERENCES

    1. Goldenberg NA, Bernard TJ. Venous thromboembolism in children. Hematol Oncol Clin North Am. 2010;24(1):151-166.
    1. Raffini L, Huang YS, Witmer C, et al. Dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001-2007. Pediatrics. 2009;124(4):1001-1008.
    1. Hilbert K, Bailey J (eds). Children’s Hospitals’ Solutions for Patient Safety Recommended Bundles. Cincinnati, OH: Solutions for Patient Safety; 2013. http://www.solutionsforpatientsafety.org/wpcontent/uploads/SPS-Recommend... (last accessed January 20, 2017)
    1. Goldenberg NA, Donadini MP, Kahn SR, et al. Post-thrombotic syndrome in children: a systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors. Haematologica. 2010;95:1952-1959.
    1. Manco-Johnson MJ. Post-thrombotic syndrome in children. Acta Haematol. 2006;115(3-4):207-213.