Risk factors for venous thromboembolism in pediatric trauma.
BACKGROUND
Venous thromboembolism (VTE) is a major source of morbidity in critically ill trauma patients. Although the incidence and risk factors for VTE after trauma in adults have been well described, similar data regarding pediatric patients are lacking.


METHODS
Pediatric (age < 16 years) trauma patients with VTE were identified from a large administrative database collated from 19 states across the United States. Risk factors for VTE were identified using multivariate techniques.


RESULTS
Risk of VTE increased with age and Injury Severity Scores. VTE was clearly associated with head, thoracic, abdominal, lower extremity, and spinal injuries. Craniotomy, laparotomy, and spinal operations were also associated with VTE. The greatest risk of VTE was in children with venous catheters.


CONCLUSIONS
Older children with high Injury Severity Scores, major vascular injury, craniotomy, or venous catheters are at risk for VTE. These data may help guide strategies geared toward screening and prophylaxis in injured children.
Vavilala
Monica S
MS
Department of Anesthesiology, University of Washington, Harborview Injury Prevention and Research Center, Seattle, Washington 98104, USA. vavilala@u.washington.edu
Nathens
Avery B
AB
Jurkovich
Gregory J
GJ
Mackenzie
Ellen
E
Rivara
Frederick P
FP
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology*; D015599:Trauma Severity Indices; D020246:Venous Thrombosis / Q000209:etiology*; D014947:Wounds and Injuries / Q000150:complications*