title: Postthrombotic syndrome and other outcomes of lower extremity deep vein thrombosis in children.
abstract: Pediatric lower extremity deep vein thrombosis (LE-DVT) can lead to postthrombotic syndrome (PTS) and other adverse events. We investigated the outcomes of LE-DVT in children. Three groups were compared: non-line-related (Non-LR) DVT, LR DVT in neonates (LRneonates), and LR DVT in non-neonates (LRnon-neonates). A total of 339 children were included (Non-LR, n = 56; LRneonates, n = 95; and LRnon-neonates, n = 188). We found a statistically significant difference in the frequency of PTS (P= .04; 62.5%, 40.0%, and 46.3% in Non-LR, LRneonates, and LRnon-neonates,respectively), of recurrent LE-DVT (P= .001; 10.7% and 2.0% in Non-LR and LRnon-neonates,respectively), and pulmonary embolism (PE) (P< .001; 19.6% and 3.2% in Non-LR and LRnon-neonates,respectively) among groups. There was no difference in DVT resolution (P= .41). Multivariable analysis showed that DVT resolution, triggering event, and sex predicted Modified Villalta Scale (MVS; for pediatric PTS) scores >1; there was an interaction between DVT triggering event and sex. The time to reach an MVS >1 was significantly different when comparing groups (log-rank test,P< .001). Moreover, we found a significant difference in baseline MVS scores among groups, but the difference did not appear to change over time. In conclusion, LR LE-DVT had more benign outcomes than Non-LR DVT. Sex, DVT triggering event, and DVT resolution predicted LE-PTS in our cohort.
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, and.
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Avila
authors.affiliation: Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, and.
authors.forename: Suzan
authors.initials: S
authors.lastname: Williams
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, and.
authors.forename: Natasha
authors.initials: N
authors.lastname: Yue
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, and.
authors.forename: Peter
authors.initials: P
authors.lastname: Krol
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, and.
authors.forename: Leonardo R
authors.initials: LR
authors.lastname: Brandão
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007866:Leg / Q000473:pathology*; D016017:Odds Ratio; D054070:Postthrombotic Syndrome / Q000209:etiology*; D011655:Pulmonary Embolism / Q000209:etiology; D012008:Recurrence; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications*