Clinical characteristics, risk factors, and outcomes of pediatric thrombosis: a prospective single-center study.

Abstract

The incidence of pediatric thrombosis is increasing due to multiple causes and risk factors, including genetic and acquired factors. This study aimed to evaluate clinical characteristics, risk factors, genetic mutations, and clinical outcomes of children with thrombosis. This prospective observational study included 40 children with thrombotic events. Detailed demographic, clinical, laboratory, and imaging data, as well as clinical outcomes, were collected. Thrombophilia gene testing included MTHFR C677T and A1298C, Factor XIII V34L, and factor V Leiden mutations. Statistical analyses included univariate comparisons and multivariate logistic regression to identify predictors of poor outcomes. Twenty percentage of the study population had genetic thrombophilia, while 80% had acquired risk factors. Acquired risk factors mainly included hematological (22.5%) and cardiac disorders (20%). Venous thrombosis was the most common site (80%), followed by arterial (10%) and cardiac (10%) thrombi. MTHFR C677T and factor XIII V34L mutations were detected with genetic thrombophilia only (P < 0.01), while factor V Leiden was present in both groups (P = 0.11). Overall, 67.5% of patients improved, 20% died, and 12.5% developed permanent disabilities. Multivariate analysis identified thrombocytopenia as an independent predictor of poor outcomes [odds ratio (OR) 18.44; 95% CI: 1.76-192.49; P = 0.02]. Positive blood cultures were associated with a fourfold increased risk of adverse outcomes (OR 4.0; 95% CI: 0.75-21.23; P = 0.1). Pediatric thrombosis was predominantly caused by acquired risk factors, though genetic mutations were significantly evident in this study. Screening and early diagnosis are essential for high-risk profiles. Identifying and managing sepsis and thrombocytopenia are critical to improving outcomes.