Evaluation of Thromboembolic Events in Patients Hospitalized in the Palliative Care Unit: A Single Center Experience.

Abstract

Objectives: Although thromboembolic events are less common in children compared with adults, complications related to thromboembolism are becoming more frequent due to improved care for children with chronic illnesses. The aim of the study was to evaluate thromboembolic events in pediatric patients hospitalized in palliative care unit (PCU).

Materials and methods: The files of the patients who were hospitalized in PCU of our hospital between January 2020 and January 2023 were retrospectively analyzed. A total of 1002 hospitalizations of 449 patients were examined.

Results: The median age was 6.1 years, F/M: 214/235. We found that 83 (18.4%) patients had thrombosis. In most patients with thrombosis, the primary diseases were malignancy and trauma. During hospitalization, the median time for detecting thrombosis was 26 days (range: 1 to 180 d). We treated 67 out of 83 thrombosis patients with low-molecular-weight heparin (LMWH) for an average of 26 days, ranging from 1 to 188 days. Unfractionated heparin was used in 2 patients, while thrombolytic therapy was used in 2 patients with massive pulmonary embolism and middle cerebral artery thrombosis. None of the thromboembolic events resulted in fatality.

Conclusions: This study revealed that the frequency of thrombosis in pediatric patients hospitalized in PCU was ∼1/5, which is significantly higher than the rates observed in childhood. Catheter-related thrombosis was more frequently observed among patients with thrombosis in the PCU, with malignancy and trauma representing the most common indications for hospitalization. Our findings suggest that certain patient groups should be evaluated for prophylactic anticoagulation.