Hospital acquired venous thromboembolism in children with sickle cell disease.

IF 1.2 4区 医学 Q4 HEMATOLOGY
Pediatric Hematology and Oncology Pub Date : 2024-10-01 Epub Date: 2024-06-05 DOI:10.1080/08880018.2024.2362147
Shreya Agarwal, Kayla L Foster, Shaniqua J Anum, Mary C Shapiro, HyoJeong Han, Michael E Scheurer, Gladstone Airewele, Sarah E Sartain
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Abstract

Sickle cell disease (SCD) is well recognized as a hypercoagulablestate, however, it remains unclear whether a subgroup of children with SCD at higher risk of venous thromboembolic event (VTE) during hospitalization may benefit from thromboprophylaxis. Our objectives were to describe the clinical characteristics, outcomes and recurrence of hospital acquired VTE in patients with SCD younger than 21 years. This was a single center retrospective study. Data regarding demographics, reason for admission, location of VTE, risk factors like central venous catheter (CVC), intensive care unit (ICU) admission among others were extracted from electronic medical records over a 10-year study period (2011-2021). Recurrence of VTE at 1 and 5 years was assessed. Descriptive statistics were used as indicated. We identified a total of 20 VTE events over the 10-year study period. Six of these events occurred in those younger than 12 years of age. Fourteen (70%) VTE events occurred in the HbSS or HbSβThal0 genotypes compared to 6 (30%) in HbSC. Most common VTE was isolated pulmonary embolism (PE) (n = 10, 50%). VTE were most often associated with acute chest syndrome (ACS) (n = 14, 70%), ICU admissions (n = 10, 50%) and CVC (n = 5/9, 55%). One patient died from the VTE event. One patient with additional underlying risk factors had a recurrent VTE at 13 months. Our study suggests that ICU admission, ACS and presence of CVC increases the risk of VTE in children and young adults with SCD, but larger studies are indicated to validate our findings.

镰状细胞病患儿在医院获得性静脉血栓栓塞症。
镰状细胞病(SCD)被公认为是一种高凝状态,但目前仍不清楚住院期间静脉血栓栓塞事件(VTE)风险较高的 SCD 儿童亚群是否能从血栓预防中获益。我们的目的是描述 21 岁以下 SCD 患者的临床特征、预后以及住院期间 VTE 的复发情况。这是一项单中心回顾性研究。研究人员从为期 10 年(2011-2021 年)的电子病历中提取了有关人口统计学、入院原因、VTE 位置、中心静脉导管(CVC)、入住重症监护室(ICU)等风险因素的数据。评估了 1 年和 5 年后 VTE 的复发情况。研究采用了描述性统计方法。在 10 年的研究期间,我们共发现了 20 起 VTE 事件。其中 6 例发生在 12 岁以下的儿童身上。14起(70%)VTE事件发生在HbSS或HbSβThal0基因型中,而在HbSC基因型中发生了6起(30%)。最常见的 VTE 是孤立性肺栓塞(PE)(10 例,50%)。VTE 最常见于急性胸部综合征 (ACS)(14 例,70%)、入住 ICU(10 例,50%)和 CVC(5/9 例,55%)。一名患者死于 VTE 事件。一名有其他潜在风险因素的患者在 13 个月后再次发生 VTE。我们的研究表明,入住 ICU、ACS 和使用 CVC 会增加儿童和年轻成人 SCD 患者发生 VTE 的风险,但需要进行更大规模的研究来验证我们的发现。
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来源期刊
CiteScore
2.60
自引率
5.90%
发文量
71
审稿时长
6-12 weeks
期刊介绍: PHO: Pediatric Hematology and Oncology covers all aspects of research and patient management within the area of blood disorders and malignant diseases of childhood. Our goal is to make PHO: Pediatric Hematology and Oncology the premier journal for the international community of clinicians and scientists who together aim to define optimal therapeutic strategies for children and young adults with cancer and blood disorders. The journal supports articles that address research in diverse clinical settings, exceptional case studies/series that add novel insights into pathogenesis and/or clinical care, and reviews highlighting discoveries and challenges emerging from consortia and conferences. Clinical studies as well as basic and translational research reports regarding cancer pathogenesis, genetics, molecular diagnostics, pharmacology, stem cells, molecular targeting, cellular and immune therapies and transplantation are of interest. Papers with a focus on supportive care, late effects and on related ethical, legal, psychological, social, cultural, or historical aspects of these fields are also appreciated. Reviews on important developments in the field are welcome. Articles from scientists and clinicians across the international community of Pediatric Hematology and Oncology are considered for publication. The journal is not dependent on or connected with any organization or society. All submissions undergo rigorous peer review prior to publication. Our Editorial Board includes experts in Pediatric Hematology and Oncology representing a wide range of academic and geographic diversity.
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