Effect of injury severity on the incidence and utilization-related outcomes of venous thromboembolism in pediatric trauma inpatients.
OBJECTIVE
The objective of this study was to generate national estimates of the effect of injury severity on the occurrence rate and associated resource utilization-related outcomes of venous thromboembolism (VTE) between pediatric and adolescent trauma inpatients in the United States.


METHODS
2003 Healthcare Cost and Utilization Project Kids' Inpatient Database, the largest all-payer pediatric (age < or =20 yrs) inpatient care database in the United States.


RESULTS
VTE was identified in 2.7 per 1000 pediatric trauma discharges. Although injury severity is strongly associated with an increased risk of VTE, the occurrence rate is low even among critically injured patients (<2%). However, VTE has a significant and an independent impact on the length of stay and hospitalization costs in the critical care setting.


CONCLUSIONS
VTE increases both the length of stay and hospitalization costs independent of injury severity, demonstrating the need to consider thromboprophylaxis in the critically injured population. However, the low overall occurrence rate of VTE in young trauma patients, even in the intensive care unit, highlights the need for additional studies of risk factors and the potential risks of prophylactic anticoagulation, so that thromboprophylaxis can be more directly targeted to the children at highest risk.
Candrilli
Sean D
SD
Department of Pharmacy Administration and Policy, The Ohio State University, College of Pharmacy, Columbus, OH, USA.
Balkrishnan
Rajesh
R
O'Brien
Sarah H
SH
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016018:Least-Squares Analysis; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D009820:Ohio / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology*; D014947:Wounds and Injuries / Q000150:complications*