title: Risk factors for venous thromboembolism after pediatric trauma.
abstract: OBJECTIVE
  The purposes of this study were to identify independent predictors of venous thromboembolism (VTE), to evaluate the relative impact of adult VTE risk factors, and to identify a pediatric population at high-risk for VTE after trauma.
  
  
  METHODS
  1934 consecutive pediatric admissions (≤ 17 years) from 01/2000 to 12/2012 at a level 1 trauma center were reviewed. Logistic regression was used to identify predictors of VTE.
  
  
  RESULTS
  Twenty-two patients (1.2%) developed a VTE, including 5% of those requiring orthopedic surgery, 14% of those with major vascular injury (MVI), and 36% of those with both. Most (84%) were diagnosed at the primary site of injury. 86% of those who developed a VTE were receiving thromboprophylaxis at the time of diagnosis. Independent predictors were age (odds ratio (OR): 1.59, 95% confidence interval (CI): 1.11-2.25), orthopedic surgery (OR: 8.10, CI: 3.10-21.39), transfusion (OR: 3.37, CI: 1.26-8.99), and MVI (OR: 15.43, CI: 5.70-41.76). When known risk factors for VTE in adults were adjusted, significant factors were age ≥ 13 years (OR: 9.16, CI: 1.08-77.89), indwelling central venous catheter (OR: 4.41, CI: 1.31-14.82), orthopedic surgery (OR: 6.80, CI: 2.47-18.74), and MVI (OR: 14.41, CI: 4.60-45.13).
  
  
  CONCLUSIONS
  MVI and orthopedic surgery are synergistic predictors of pediatric VTE. Most children who developed a VTE were receiving thromboprophylaxis at the time of diagnosis.
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Casey J
authors.initials: CJ
authors.lastname: Allen
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Clark R
authors.initials: CR
authors.lastname: Murray
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Meizoso
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Juliet J
authors.initials: JJ
authors.lastname: Ray
authors.affiliation: Division of Pediatric Surgery, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Holly L
authors.initials: HL
authors.lastname: Neville
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
authors.affiliation: Division of Pediatric Surgery, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
authors.affiliation: Division of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address: kproctor@miami.edu.
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Proctor
mesh_terms: D000367:Age Factors; D000991:Antithrombins / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D019637:Orthopedic Procedures / Q000009:adverse effects; D012307:Risk Factors; D014193:Trauma Centers; D014481:United States / Q000453:epidemiology; D057772:Vascular System Injuries / Q000150:complications; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D000991:Antithrombins
keywords: Children; DVT; Deep vein thrombosis; Pediatrics; Trauma; VTE