title: Venous thromboembolism in pediatric patients: a single institution experience in Korea.
abstract: BACKGROUND
  While venous thromboembolism (VTE) is uncommon, its incidence is increasing in children. We aimed to evaluate the incidence, risk factors, treatment, and outcome of pediatric VTE cases at a single tertiary hospital in Korea.
  
  
  METHODS
  We retrospectively analyzed the records of consecutive pediatric VTE patients admitted to the Seoul National University Bundang Hospital between April 2003 and March 2016.
  
  
  RESULTS
  Among 70,462 hospitalizations, 25 pediatric VTE cases were identified (3.27 cases per 10,000 admissions). Fifteen patients (60%) were male, 8 were neonates (32%), and the median age at diagnosis was 10.9 years (range, 0 days‒17 yr). Doppler ultrasonography was the most frequently used imaging modality. Thrombosis occurred in the intracerebral (20%), upper venous (64%), lower venous (12%), and combined upper and lower venous systems (4%). Twenty patients (80%) had underlying clinical conditions including venous catheterization (24%), malignancy (20%), and systemic diseases (12%). Protein C, protein S, and antithrombin deficiencies occurred in 2 of 13, 4 of 13, and 1 of 14 patients tested, respectively. Six patients were treated with heparin followed by warfarin, while 4 were treated with heparin or warfarin. Thrombectomy and inferior vena cava filter and/or thrombolysis were performed in 5 patients. Two patients died of pulmonary embolism, and 2 developed a post-thrombotic syndrome.
  
  
  CONCLUSIONS
  Compared with the reports from Western countries, VTE occurrence was lower in the Korean pediatric population under study, although similar clinical characteristics including bimodal age distribution, underlying diseases, treatment pattern, and outcomes were observed.
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hyoung Soo
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Heon Min
authors.initials: HM
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Park
keywords: Epidemiology; Pediatric patients; Venous thromboembolism