The impact of femoral arterial thrombosis in paediatric cardiac catheterisation: a national study.
BACKGROUND
Previous studies have identified risk factors for femoral arterial thrombosis after paediatric cardiac catheterisation, but none of them have evaluated the clinical and economic significance of this complication at the population level. Therefore, we examined the national prevalence and economic impact of femoral arterial thrombosis after cardiac catheterisation in children.


METHODS
Patients⩽18 years of age who underwent cardiac catheterisation were identified in the 2003-2009 Kids' Inpatient Database. Patients were stratified by age as follows: <1 year of age or 1-18 years of age. The primary outcome was arterial thrombosis of the lower extremity during the same hospitalisation as cardiac catheterisation. Propensity score matching was used to determine the impact of femoral arterial thrombosis on hospital length of stay, cost, and mortality.


RESULTS
Among the 11,497 paediatric cardiac catheterisations identified, 4558 catheterisations (39.6%) were performed in children <1 year of age. This age group experienced a higher prevalence of reported femoral arterial thrombosis, compared with children aged 1-18 years (1.3 versus 0.3%, p<0.001). After matching, femoral arterial thrombosis in children <1 year of age was associated with similar mortality (5.4 versus 1.8%, p=0.28), length of stay (8 versus 5 days, p=0.11), and total hospital cost ($27,135 versus $28,311, p=0.61), compared with absence of thrombosis.


CONCLUSIONS
Femoral arterial thrombosis is especially prevalent in children <1 year of age undergoing cardiac catheterisation. Clinicians should be vigilant in monitoring femoral arterial patency in neonates and infants after cardiac catheterisation.
1Department of Surgery,Duke University Medical Center,Durham,North Carolina,United States of America.
Jina
J
Kim
1Department of Surgery,Duke University Medical Center,Durham,North Carolina,United States of America.
Zhifei
Z
Sun
1Department of Surgery,Duke University Medical Center,Durham,North Carolina,United States of America.
Ehsan
E
Benrashid
1Department of Surgery,Duke University Medical Center,Durham,North Carolina,United States of America.
Kevin W
KW
Southerland
1Department of Surgery,Duke University Medical Center,Durham,North Carolina,United States of America.
Jeffrey H
JH
Lawson
2Department of Cardiology,Duke University Medical Center,Durham,North Carolina,United States of America.
Gregory A
GA
Fleming
2Department of Cardiology,Duke University Medical Center,Durham,North Carolina,United States of America.
Kevin D
KD
Hill
1Department of Surgery,Duke University Medical Center,Durham,North Carolina,United States of America.
Elisabeth T
ET
Tracy
D000293:Adolescent; D017677:Age Distribution; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology*; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology*; D014481:United States / Q000453:epidemiology
CHD; cardiac catheterisation; child; femoral artery