Elizabeth E Halvorson1, Sean E Ervin2, Thomas B Russell2, Joseph A Skelton3, Stephen Davis4, John Spangler4. 1. Departments of Pediatrics, ehalvors@wakehealth.edu. 2. Departments of Pediatrics. 3. Departments of Pediatrics, Brenner FIT (Families in Training), Brenner Children's Hospital, Winston-Salem, North Carolina Epidemiology and Prevention, Division of Public Health Sciences, and. 4. Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; and.
Abstract
BACKGROUND: The incidence of venous thromboembolism (VTE) is increasing among pediatric patients in the United States. Previous studies on obesity as a risk factor have produced mixed results. METHODS: We completed a retrospective chart review of patients aged 2 to 18 years with VTE identified by using International Classification of Diseases, Ninth Revision, codes and confirmed by imaging. Patients were admitted between January 2000 and September 2012. Control subjects were matched on age, gender, and the presence of a central venous catheter. Data were collected on weight, height, and risk factors, including bacteremia, ICU admission, immobilization, use of oral contraceptives, and malignancy. Underweight patients and those without documented height and weight data were excluded. Independent predictors of VTE risk were identified by using univariate and multivariate analyses. RESULTS: We identified 88 patients plus 2 matched control subjects per case. The majority of cases were nonembolic events (77%) of the lower extremity (25%) or head and neck (22%) confirmed by ultrasound (43%) or computed tomography scan (41%). A statistically significant association was found between VTE and increased BMI z score (P = .002). In multivariate analysis, BMI z score (odds ratio [OR]: 3.1; P = .007), bacteremia (OR: 4.9; P = .02), ICU stay (OR: 2.5; P = .02), and use of oral contraceptives (OR: 17.4; P < .001) were significant predictors. CONCLUSIONS: In this single-institution study, the diagnosis of VTE was significantly associated with overweight and obesity. Further study is needed to fully define this association.
BACKGROUND: The incidence of venous thromboembolism (VTE) is increasing among pediatric patients in the United States. Previous studies on obesity as a risk factor have produced mixed results. METHODS: We completed a retrospective chart review of patients aged 2 to 18 years with VTE identified by using International Classification of Diseases, Ninth Revision, codes and confirmed by imaging. Patients were admitted between January 2000 and September 2012. Control subjects were matched on age, gender, and the presence of a central venous catheter. Data were collected on weight, height, and risk factors, including bacteremia, ICU admission, immobilization, use of oral contraceptives, and malignancy. Underweight patients and those without documented height and weight data were excluded. Independent predictors of VTE risk were identified by using univariate and multivariate analyses. RESULTS: We identified 88 patients plus 2 matched control subjects per case. The majority of cases were nonembolic events (77%) of the lower extremity (25%) or head and neck (22%) confirmed by ultrasound (43%) or computed tomography scan (41%). A statistically significant association was found between VTE and increased BMI z score (P = .002). In multivariate analysis, BMI z score (odds ratio [OR]: 3.1; P = .007), bacteremia (OR: 4.9; P = .02), ICU stay (OR: 2.5; P = .02), and use of oral contraceptives (OR: 17.4; P < .001) were significant predictors. CONCLUSIONS: In this single-institution study, the diagnosis of VTE was significantly associated with overweight and obesity. Further study is needed to fully define this association.
Authors: Brian R Branchford; Peter Mourani; Lalit Bajaj; Marilyn Manco-Johnson; Michael Wang; Neil A Goldenberg Journal: Haematologica Date: 2011-12-01 Impact factor: 9.941
Authors: Janelle D Vaughns; Victoria C Ziesenitz; Elaine F Williams; Evan P Nadler; Gerd Mikus; Johannes van den Anker Journal: Obes Surg Date: 2020-01 Impact factor: 4.129
Authors: Jens Sundbøll; Lars Ängquist; Kasper Adelborg; Line Klingen Gjærde; Anne Ording; Thorkild I A Sørensen; Jennifer L Baker; Henrik Toft Sørensen Journal: J Am Heart Assoc Date: 2019-03-19 Impact factor: 5.501