title: Association of Obesity and Pediatric Venous Thromboembolism.
abstract: BACKGROUND
  The incidence of venous thromboembolism (VTE) is increasing among pediatric patients in the United States. Previous studies on obesity as a risk factor have produced mixed results.
  
  
  METHODS
  We completed a retrospective chart review of patients aged 2 to 18 years with VTE identified by using International Classification of Diseases, Ninth Revision, codes and confirmed by imaging. Patients were admitted between January 2000 and September 2012. Control subjects were matched on age, gender, and the presence of a central venous catheter. Data were collected on weight, height, and risk factors, including bacteremia, ICU admission, immobilization, use of oral contraceptives, and malignancy. Underweight patients and those without documented height and weight data were excluded. Independent predictors of VTE risk were identified by using univariate and multivariate analyses.
  
  
  RESULTS
  We identified 88 patients plus 2 matched control subjects per case. The majority of cases were nonembolic events (77%) of the lower extremity (25%) or head and neck (22%) confirmed by ultrasound (43%) or computed tomography scan (41%). A statistically significant association was found between VTE and increased BMI z score (P = .002). In multivariate analysis, BMI z score (odds ratio [OR]: 3.1; P = .007), bacteremia (OR: 4.9; P = .02), ICU stay (OR: 2.5; P = .02), and use of oral contraceptives (OR: 17.4; P < .001) were significant predictors.
  
  
  CONCLUSIONS
  In this single-institution study, the diagnosis of VTE was significantly associated with overweight and obesity. Further study is needed to fully define this association.
authors.affiliation: Departments of Pediatrics, ehalvors@wakehealth.edu.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Halvorson
authors.affiliation: Departments of Pediatrics.
authors.forename: Sean E
authors.initials: SE
authors.lastname: Ervin
authors.affiliation: Departments of Pediatrics.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Russell
authors.affiliation: Departments of Pediatrics, Brenner FIT (Families in Training), Brenner Children's Hospital, Winston-Salem, North Carolina Epidemiology and Prevention, Division of Public Health Sciences, and.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Skelton
authors.affiliation: Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; and.
authors.forename: Stephen
authors.initials: S
authors.lastname: Davis
authors.affiliation: Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; and.
authors.forename: John
authors.initials: J
authors.lastname: Spangler
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005260:Female; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy