title: The incidence of catheter-associated venous thrombosis in noncritically ill children.
abstract: OBJECTIVE
  Previous studies estimated the incidence of catheter-associated venous thrombosis to be between 2% and 81%. Our goals were to define the incidence rate of catheter-related thrombosis in a hospitalized, noncritically ill, pediatric population and to determine modifiable factors that alter the risk of thrombosis.
  
  
  METHODS
  A retrospective cohort study was performed at the North Carolina Children's Hospital from 2009 to 2012. Chart review was performed with extraction of patient characteristics and line-related variables. Presence of symptomatic catheter-associated venous thrombosis was the primary outcome. Bivariable analysis and multivariable logistic regression were used to explore associations between line-related variables and thrombosis.
  
  
  RESULTS
  A total of 1135 lines were placed in 815 patients for 118,023 catheter-days. Thirty-six were complicated by venous thrombosis (3.2%) yielding a rate of 0.3 events per 1000 catheter-days. In multivariable analysis, increasing age (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.03-1.13; P=.002), renal dialysis (OR 3.2, 95% CI 1.09-9.66; P=.035), and a diagnosis of inflammatory bowel disease or short bowel syndrome (OR 4.3, 95% CI 1.2-15.0; P=.02) were associated with increased risk of thrombosis. Modifiable risk factors, such as line site, size, and lumens, were not significantly associated with thrombosis. No thromboembolic events were observed.
  
  
  CONCLUSIONS
  We observed a lower incidence rate of catheter-associated venous thrombosis than in most previous reports. No modifiable characteristics altered the risk of thrombosis. Additional investigation of measures to prevent thrombosis is warranted in higher-risk populations, such as patients undergoing dialysis or patients with inflammatory bowel disease.
authors: Division of Pediatric Hematology Oncology, UNC Lineberger Comprehensive Cancer Center, North Carolina Cancer Hospital, Chapel Hill, North Carolina; and andrew_smitherman@med.unc.edu.
authors: Andrew B
authors: AB
authors: Smitherman
authors: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, and Department of Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
authors: Thomas
authors: T
authors: Alexander
authors: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, and.
authors: Mark
authors: M
authors: Connelly
authors: UNC Lineberger Comprehensive Cancer Center, North Carolina Cancer Hospital, Chapel Hill, North Carolina; and Department of Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
authors: Anna C
authors: AC
authors: Snavely
authors: Division of Pediatric Hematology Oncology, UNC Lineberger Comprehensive Cancer Center, North Carolina Cancer Hospital, Chapel Hill, North Carolina; and UNC Hemophilia and Thrombosis Center, Chapel Hill, North Carolina.
authors: Brent W
authors: BW
authors: Weston
authors: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, and Department of Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
authors: Edmund A
authors: EA
authors: Liles
authors: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, and.
authors: Michael J
authors: MJ
authors: Steiner
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D056824:Upper Extremity Deep Vein Thrombosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology
keywords: central venous catheter (CVC); deep vein thrombosis; peripherally inserted central catheter (PICC); port-a-cath; thrombosis; venous thromboembolism