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Meta-Analysis
. 2023 Jun 15;23(1):292.
doi: 10.1186/s12887-023-04122-x.

Epidemiology and risk factors for thrombosis in children and newborns: systematic evaluation and meta-analysis

Shuang Song  1 , Zhuowei Li  2 , Guozhen Zhao  3 , Xintong Li  1 , Runying Wang  1 , Bo Li  4   5 , Qingquan Liu  6
Affiliations
Meta-Analysis

Epidemiology and risk factors for thrombosis in children and newborns: systematic evaluation and meta-analysis

Shuang Song et al. BMC Pediatr. .

Abstract

Background: Thrombosis is a serious condition in children and neonates. However, the risk factors for thrombosis have not been conclusively determined. This study aimed to identify the risk factors for thrombosis in children and neonates in Intensive Care Unit (ICU) through a meta-analysis to better guide clinical treatment.

Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, WOS, CNKI, Wanfang, VIP) was conducted to retrieve studies from creation on 23 May 2022. Data on the year of publication, study design, country of origin, number of patients/controls, ethnicity, and type of thrombus were extracted. The publication bias and heterogeneity between studies were assessed, and pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed or random effects models.

Results: A total of 18 studies met the inclusion criteria. The incidence of thrombosis in children was 2% per year (95% CI 1%-2%, P < 0.01). Infection and sepsis (OR = 1.95, P < 0.01), CVC (OR = 3.66, [95%CL 1.78-7.51], P < 0.01), mechanical ventilation (OR = 2.1, [95%CL1.47-3.01], P < 0.01), surgery (OR = 2.25, [95%CL1.2-4.22], P < 0.01), respiratory distress (OR = 1.39, [95%CL0.42-4.63], P < 0.01), ethnicities (OR = 0.88, [95%CL 0.79-0.98], P = 0.78), gestational age (OR = 1.5, [95%CL1.34-1.68], P = 0.65)were identified as risk factors for thrombosis.

Conclusions: This meta-analysis suggests that CVC, Surgery, mechanical ventilation, Infection/sepsis, gestational age, Respiratory distress, and different ethnicities are risk factors for thrombosis in children and neonates in ICU. These findings may help clinicians to identify high-risk patients and develop appropriate prevention strategies.

Trial registration: PROSPERO (CRD 42022333449).

Keywords: Epidemiology; Meta-analysis; Newborns; Risk factors; Thrombosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Literature search process
Fig. 2
Fig. 2
Forest plots for Meta-analysis of prevalence in the literature of thrombosis studies in children in ICUs by country
Fig. 3
Fig. 3
Forest plots for Meta-analysis of influencing factors in the literature on thrombosis studies in children in the ICU, Reported the effects of different influencing factors on thrombosis in children; A Sepsis, B CVC, C Mechanical ventilation, D Ethnicity, E Age, F Surgery, G Respiratory distress
Fig. 4
Fig. 4
Sensitivity analysis of publication bias in children's thrombosis incidence, infection and sepsis, and CVC research literature, The OR value is the abscissa; A Sepsis, B CVC, C Mechanical ventilation
Fig. 5
Fig. 5
CVC influencing factors remove heterogeneity after interfering with the article
See this image and copyright information in PMC

References

    1. Levy-Mendelovich S, Cohen O, Klang E, Kenet G. 50 Years of pediatric hemostasis: knowledge, diagnosis, and treatment. Semin Thromb Hemost. 2023;49(3):217–224. doi: 10.1055/s-0042-1756704. - DOI - PubMed
    1. Betensky M, Kulkarni K, Rizzi M, Jones S, Brandão LR, Faustino EVS, Goldenberg NA, Sharathkumar A. Recommendations for standardized definitions, clinical assessment, and future research in pediatric clinically unsuspected venous thromboembolism: Communication from the ISTH SSC subcommittee on pediatric and neonatal thrombosis and hemostasis. J Thrombosis Haemostasis. 2022;20(7):1729–1734. doi: 10.1111/jth.15731. - DOI - PMC - PubMed
    1. Bhatt MD, Chan AK. Venous thrombosis in neonates Faculty reviews. 2021;10:20. - PMC - PubMed
    1. Edstrom CS, Christensen RD. Evaluation and treatment of thrombosis in the neonatal intensive care unit. Clin Perinatol. 2000;27(3):623–641. doi: 10.1016/S0095-5108(05)70042-7. - DOI - PubMed
    1. Thom K, Lensing AWA, Nurmeev I, Bajolle F, Bonnet D, Kenet G, Massicotte MP, Karakas Z, Palumbo JS, Saracco P, et al. Safety and efficacy of anticoagulant therapy in pediatric catheter-related venous thrombosis (EINSTEIN-Jr CVC-VTE) Blood Adv. 2020;4(19):4632–4639. doi: 10.1182/bloodadvances.2020002637. - DOI - PMC - PubMed

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