BACKGROUND: Chronic renal diseases (CRD) are associated with approximately 5% of pediatric venous thromboembolism (VTE) cases, but the epidemiology of VTE in CRD is ill-defined. METHODS: Children (<18 years) with CRD were identified from MarketScan® Research databases. The VTE status of subjects with CRD who qualified for this study was ascertained during the 6 months following the initial diagnosis of CRD. Demographics, healthcare utilization, mortality, and co-morbid conditions were assessed. RESULTS: A total of 22,877 children with predefined CRD ICD-9-CM codes were identified between April 1, 2003 and June 30, 2012, among whom 0.55% had VTE. Our analysis revealed that in-hospital mortality was more likely in children with VTE than in those without VTE (11.9 vs. 0.9%, respectively; p < 0.0001). The usage of healthcare facilities, based on the number of inpatient admissions, length of stay, outpatient visits, and pharmaceutical claims, was also significantly higher in patients with VTE than in those without (p < 0.0001). Total mean healthcare expenditures for the 6-month follow-up period were 13-fold greater in the VTE group than in the group without VTE ($338,338 ± $544,045 vs. $25,171 ± $90,792; p < 0.0001). In a multivariate model, infection, hemodialysis, and trauma/surgery significantly increased the likelihood of VTE. CONCLUSIONS: Venous thromboembolism is rare in children with CRD, but it is associated with higher mortality and healthcare utilization when present. Among the children with CRD enrolled in our study, the likelihood of VTE was increased among those with co-morbid, non-renal chronic conditions.
BACKGROUND:Chronic renal diseases (CRD) are associated with approximately 5% of pediatric venous thromboembolism (VTE) cases, but the epidemiology of VTE in CRD is ill-defined. METHODS:Children (<18 years) with CRD were identified from MarketScan® Research databases. The VTE status of subjects with CRD who qualified for this study was ascertained during the 6 months following the initial diagnosis of CRD. Demographics, healthcare utilization, mortality, and co-morbid conditions were assessed. RESULTS: A total of 22,877 children with predefined CRD ICD-9-CM codes were identified between April 1, 2003 and June 30, 2012, among whom 0.55% had VTE. Our analysis revealed that in-hospital mortality was more likely in children with VTE than in those without VTE (11.9 vs. 0.9%, respectively; p < 0.0001). The usage of healthcare facilities, based on the number of inpatient admissions, length of stay, outpatient visits, and pharmaceutical claims, was also significantly higher in patients with VTE than in those without (p < 0.0001). Total mean healthcare expenditures for the 6-month follow-up period were 13-fold greater in the VTE group than in the group without VTE ($338,338 ± $544,045 vs. $25,171 ± $90,792; p < 0.0001). In a multivariate model, infection, hemodialysis, and trauma/surgery significantly increased the likelihood of VTE. CONCLUSIONS:Venous thromboembolism is rare in children with CRD, but it is associated with higher mortality and healthcare utilization when present. Among the children with CRD enrolled in our study, the likelihood of VTE was increased among those with co-morbid, non-renal chronic conditions.
Authors: Rita D Sheth; Mary L Brandt; Eileen D Brewer; Jed G Nuchtern; Arundhati S Kale; Stuart L Goldstein Journal: Kidney Int Date: 2002-11 Impact factor: 10.612
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Authors: P M Mannucci; G Remuzzi; F Pusineri; R Lombardi; C Valsecchi; G Mecca; T S Zimmerman Journal: N Engl J Med Date: 1983-01-06 Impact factor: 91.245
Authors: Shannon L Carpenter; Jennifer Goldman; Ashley K Sherman; David T Selewski; Mahmoud Kallash; Cheryl L Tran; Meredith Seamon; Chryso Katsoufis; Isa Ashoor; Joel Hernandez; Katarina Supe-Markovina; Cynthia D'alessandri-Silva; Nilka DeJesus-Gonzalez; Tetyana L Vasylyeva; Cassandra Formeck; Christopher Woll; Rasheed Gbadegesin; Pavel Geier; Prasad Devarajan; William E Smoyer; Bryce A Kerlin; Michelle N Rheault Journal: Pediatr Nephrol Date: 2018-09-07 Impact factor: 3.714
Authors: Amanda P Waller; Shipra Agrawal; Katelyn J Wolfgang; Jiro Kino; Melinda A Chanley; William E Smoyer; Bryce A Kerlin Journal: Physiol Rep Date: 2020-08