Riten Kumar1, Vilmarie Rodriguez2, Jane M S Matsumoto3, Shakila P Khan2, Amy L Weaver4, Robert D McBane5, Timothy J Beebe6, John A Heit7. 1. Division of Pediatric Hematology Oncology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. 2. Division of Pediatric Hematology Oncology, Mayo Clinic, Rochester, MN, USA. 3. Department of Radiology, Mayo Clinic, Rochester, MN, USA. 4. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. 5. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. 6. Department of Epidemiology, Mayo Clinic, Rochester, MN, USA. 7. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA; Department of Epidemiology, Mayo Clinic, Rochester, MN, USA. Electronic address: heit.john@mayo.edu.
Abstract
BACKGROUND: While post thrombotic syndrome (PTS) is increasingly recognized as a frequent and potentially serious complication of deep vein thrombosis (DVT) in children, limited information is available regarding predictors of PTS. METHODS: Using the Mayo Clinic Master Diagnostic Index, all pediatric patients (age 0 to 18 years) with a potential DVT based on ICD-8 codes over the 15-year period, 1995 to 2009 were identified. A validated PTS survey instrument was mailed to eligible patients followed by a second mailing and three reminder phone calls for non-responders. Baseline clinical and radiographic characteristics were abstracted from patient medical records and tested as potential predictors of PTS using logistic regression. Associations were summarized by calculating odds ratios (OR) and corresponding 95% confidence intervals. RESULTS: Ninety patients agreed to participate. The mean age (±SD) at DVT diagnosis and survey completion were 12.8 (±6.1) and 19.3 (±7.7) years, respectively. Fifty three respondents (59%) reported mild PTS whereas 12 (13%) reported moderate-to-severe PTS. Pain (34%) and dilated blood vessels (40%) were the most frequent PTS symptom and sign, respectively. On multivariate analysis, predictors of PTS included duration between incident DVT and survey completion (OR 1.75; 95% CI: 1.08-2.84) and number of thrombosed vein segments (OR 1.40; 95% CI: 1.05-1.86). CONCLUSION: Over 70% of children with DVT report subsequent symptoms or signs of PTS, though only 13% report clinically significant, moderate-to-severe PTS. Number of thrombosed vein segments at diagnosis and time duration between incident DVT and survey completion were independent predictors of PTS.
BACKGROUND: While post thrombotic syndrome (PTS) is increasingly recognized as a frequent and potentially serious complication of deep vein thrombosis (DVT) in children, limited information is available regarding predictors of PTS. METHODS: Using the Mayo Clinic Master Diagnostic Index, all pediatric patients (age 0 to 18 years) with a potential DVT based on ICD-8 codes over the 15-year period, 1995 to 2009 were identified. A validated PTS survey instrument was mailed to eligible patients followed by a second mailing and three reminder phone calls for non-responders. Baseline clinical and radiographic characteristics were abstracted from patient medical records and tested as potential predictors of PTS using logistic regression. Associations were summarized by calculating odds ratios (OR) and corresponding 95% confidence intervals. RESULTS: Ninety patients agreed to participate. The mean age (±SD) at DVT diagnosis and survey completion were 12.8 (±6.1) and 19.3 (±7.7) years, respectively. Fifty three respondents (59%) reported mild PTS whereas 12 (13%) reported moderate-to-severe PTS. Pain (34%) and dilated blood vessels (40%) were the most frequent PTS symptom and sign, respectively. On multivariate analysis, predictors of PTS included duration between incident DVT and survey completion (OR 1.75; 95% CI: 1.08-2.84) and number of thrombosed vein segments (OR 1.40; 95% CI: 1.05-1.86). CONCLUSION: Over 70% of children with DVT report subsequent symptoms or signs of PTS, though only 13% report clinically significant, moderate-to-severe PTS. Number of thrombosed vein segments at diagnosis and time duration between incident DVT and survey completion were independent predictors of PTS.
Authors: Riten Kumar; Katherine Harsh; Surbhi Saini; Sarah H O'Brien; Joseph Stanek; Patrick Warren; Jean Giver; Michael R Go; Bryce A Kerlin Journal: J Pediatr Date: 2018-12-07 Impact factor: 4.406
Authors: Laura Avila; Noelle Cullinan; Michael White; Marian Gaballah; Anne Marie Cahill; Deepti Warad; Vilmarie Rodriguez; Cristina Tarango; Anna Hoppmann; Stephen Nelson; Tomas Kuhn; Tina Biss; Aaron Weiss; Michael Temple; João G Amaral; Nour Amiri; Ana C Xavier; Samuele Renzi; Leonardo R Brandão Journal: J Thromb Haemost Date: 2021-04-01 Impact factor: 5.824
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