Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a retrospective study
The risk factors associated with the probability of central venous access device (CVAD)-associated deep vein thrombosis (DVT) resolution have been hardly evaluated in children. Current guidelines suggest anticoagulation for a maximum of 3 months in patients with provoked DVT if the provoking factor...
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| Veröffentlicht in: | European journal of pediatrics 2021-06, Vol.180 (6), p.1907-1914 |
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| creator | García-Boyano, Miguel Caballero-Caballero, José Manuel García Fernández de Villalta, Marta Gutiérrez Alvariño, Mar Blanco Bañares, María Jesús Climent Alcalá, Francisco José |
| description | The risk factors associated with the probability of central venous access device (CVAD)-associated deep vein thrombosis (DVT) resolution have been hardly evaluated in children. Current guidelines suggest anticoagulation for a maximum of 3 months in patients with provoked DVT if the provoking factor is resolved. To know if the thrombus will resolve after anticoagulant therapy will help to choose whether to initiate and/or continue this treatment or not. We did a retrospective study of 85 pediatric patients (45 girls, 40 boys) with CVAD-associated DVT to examine the risk factors associated with lack of thrombus resolution in the first 6 months after diagnosis. Sixty-two children had their thrombosis resolved after a median of 50 days (p25-p75 25–97) since diagnosis. In multivariate analysis, variables significantly associated with no resolution were total occlusion (OR 12.50, 95% CI 2.99–52.14,
p
=.001), location in upper extremity, head, and neck veins (OR 17.70, 95% CI 1.64–191.43,
p
=.018); collateral circulation in the first 45 days after diagnosis (OR 33.55, 95% CI 2.42–464.71,
p
=.009); and having between 0 and 3 prothrombotic risk factors at diagnosis (OR 6.20, 95% CI 1.21–31.75,
p
=.029).
Conclusion
: CVAD-associated DVT resolution in children in the first 6 months since diagnosis was significantly lower if the thrombosis was occlusive, if it was located in the upper extremity, head, and neck veins; if collateral circulation was seen on ultrasound in the first 45 days; and/or when the patient showed less prothrombotic risk factors at diagnosis.
What is Known:
•
The risk factors associated with central venous access device-associated deep vein thrombosis resolution have been hardly evaluated in children.
•
Current guidelines suggest anticoagulation for a maximum of 3 months in provoked vein thrombosis if the provoking factor is resolved.
What is New:
•
Thrombus resolution was lower if it was occlusive, located in the upper extremity veins, if collateral circulation was seen, and with less prothrombotic risk factors at diagnosis.
•
To know if the thrombus will resolve after anticoagulation will help to choose whether to initiate and/or continue it or not. |
| doi_str_mv | 10.1007/s00431-021-03985-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2487431730</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2487431730</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-5b43b32b9932aa657b0e6296bb9399cae575abb132e280db2dbd53331497702e3</originalsourceid><addsrcrecordid>eNp9kU9rFTEUxYMo9ln9Ai4k4MbNaP5MJi_upFhbKBRKXYckc1-bOpM8czMPuvaLN6-vKrhwEQI5v3OSm0PIW84-csb0J2Ssl7xjoi1p1qpTz8iK91J0nOnhOVkx2bNu4MYckVeId6yZDF-_JEdSKqV6oVfk11XEH3TjQs0F6QgVyhxTTDc0QKrFTXQHKS9IXQiAe2IXA3QOMYfoKoztBLYNionW25JnnzEiLYB5WmrMiTYh3MZpLJA-U9eUWjJuIdS4A4p1Ge9fkxcbNyG8edqPyffTr9cnZ93F5bfzky8XXZBiqJ3yvfRSeGOkcG5Q2jMYhBm8N9KY4EBp5bznUoBYs9GL0Y9KSsl7ozUTII_Jh0PutuSfC2C1c8QA0-QStBGt6Ne6faiWrKHv_0Hv8lJSe50VSgijFRtUo8SBCm0kLLCx2xJnV-4tZ3ZfkT1UZFtF9rEiuze9e4pe_AzjH8vvThogDwA2Kd1A-Xv3f2IfAHF1nhA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2522975065</pqid></control><display><type>article</type><title>Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a retrospective study</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>García-Boyano, Miguel ; Caballero-Caballero, José Manuel ; García Fernández de Villalta, Marta ; Gutiérrez Alvariño, Mar ; Blanco Bañares, María Jesús ; Climent Alcalá, Francisco José</creator><creatorcontrib>García-Boyano, Miguel ; Caballero-Caballero, José Manuel ; García Fernández de Villalta, Marta ; Gutiérrez Alvariño, Mar ; Blanco Bañares, María Jesús ; Climent Alcalá, Francisco José</creatorcontrib><description>The risk factors associated with the probability of central venous access device (CVAD)-associated deep vein thrombosis (DVT) resolution have been hardly evaluated in children. Current guidelines suggest anticoagulation for a maximum of 3 months in patients with provoked DVT if the provoking factor is resolved. To know if the thrombus will resolve after anticoagulant therapy will help to choose whether to initiate and/or continue this treatment or not. We did a retrospective study of 85 pediatric patients (45 girls, 40 boys) with CVAD-associated DVT to examine the risk factors associated with lack of thrombus resolution in the first 6 months after diagnosis. Sixty-two children had their thrombosis resolved after a median of 50 days (p25-p75 25–97) since diagnosis. In multivariate analysis, variables significantly associated with no resolution were total occlusion (OR 12.50, 95% CI 2.99–52.14,
p
=.001), location in upper extremity, head, and neck veins (OR 17.70, 95% CI 1.64–191.43,
p
=.018); collateral circulation in the first 45 days after diagnosis (OR 33.55, 95% CI 2.42–464.71,
p
=.009); and having between 0 and 3 prothrombotic risk factors at diagnosis (OR 6.20, 95% CI 1.21–31.75,
p
=.029).
Conclusion
: CVAD-associated DVT resolution in children in the first 6 months since diagnosis was significantly lower if the thrombosis was occlusive, if it was located in the upper extremity, head, and neck veins; if collateral circulation was seen on ultrasound in the first 45 days; and/or when the patient showed less prothrombotic risk factors at diagnosis.
What is Known:
•
The risk factors associated with central venous access device-associated deep vein thrombosis resolution have been hardly evaluated in children.
•
Current guidelines suggest anticoagulation for a maximum of 3 months in provoked vein thrombosis if the provoking factor is resolved.
What is New:
•
Thrombus resolution was lower if it was occlusive, located in the upper extremity veins, if collateral circulation was seen, and with less prothrombotic risk factors at diagnosis.
•
To know if the thrombus will resolve after anticoagulation will help to choose whether to initiate and/or continue it or not.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-021-03985-5</identifier><identifier>PMID: 33555427</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anticoagulants ; Blood clots ; Child ; Children ; Diagnosis ; Female ; Humans ; Male ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Occlusion ; Original Article ; Patients ; Pediatrics ; Retrospective Studies ; Risk Factors ; Thrombosis ; Ultrasonography ; Ultrasound ; Veins ; Veins & arteries ; Venous access ; Venous Thrombosis - diagnostic imaging ; Venous Thrombosis - drug therapy ; Venous Thrombosis - etiology</subject><ispartof>European journal of pediatrics, 2021-06, Vol.180 (6), p.1907-1914</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-5b43b32b9932aa657b0e6296bb9399cae575abb132e280db2dbd53331497702e3</cites><orcidid>0000-0002-3717-4819</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00431-021-03985-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00431-021-03985-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33555427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García-Boyano, Miguel</creatorcontrib><creatorcontrib>Caballero-Caballero, José Manuel</creatorcontrib><creatorcontrib>García Fernández de Villalta, Marta</creatorcontrib><creatorcontrib>Gutiérrez Alvariño, Mar</creatorcontrib><creatorcontrib>Blanco Bañares, María Jesús</creatorcontrib><creatorcontrib>Climent Alcalá, Francisco José</creatorcontrib><title>Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a retrospective study</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><addtitle>Eur J Pediatr</addtitle><description>The risk factors associated with the probability of central venous access device (CVAD)-associated deep vein thrombosis (DVT) resolution have been hardly evaluated in children. Current guidelines suggest anticoagulation for a maximum of 3 months in patients with provoked DVT if the provoking factor is resolved. To know if the thrombus will resolve after anticoagulant therapy will help to choose whether to initiate and/or continue this treatment or not. We did a retrospective study of 85 pediatric patients (45 girls, 40 boys) with CVAD-associated DVT to examine the risk factors associated with lack of thrombus resolution in the first 6 months after diagnosis. Sixty-two children had their thrombosis resolved after a median of 50 days (p25-p75 25–97) since diagnosis. In multivariate analysis, variables significantly associated with no resolution were total occlusion (OR 12.50, 95% CI 2.99–52.14,
p
=.001), location in upper extremity, head, and neck veins (OR 17.70, 95% CI 1.64–191.43,
p
=.018); collateral circulation in the first 45 days after diagnosis (OR 33.55, 95% CI 2.42–464.71,
p
=.009); and having between 0 and 3 prothrombotic risk factors at diagnosis (OR 6.20, 95% CI 1.21–31.75,
p
=.029).
Conclusion
: CVAD-associated DVT resolution in children in the first 6 months since diagnosis was significantly lower if the thrombosis was occlusive, if it was located in the upper extremity, head, and neck veins; if collateral circulation was seen on ultrasound in the first 45 days; and/or when the patient showed less prothrombotic risk factors at diagnosis.
What is Known:
•
The risk factors associated with central venous access device-associated deep vein thrombosis resolution have been hardly evaluated in children.
•
Current guidelines suggest anticoagulation for a maximum of 3 months in provoked vein thrombosis if the provoking factor is resolved.
What is New:
•
Thrombus resolution was lower if it was occlusive, located in the upper extremity veins, if collateral circulation was seen, and with less prothrombotic risk factors at diagnosis.
•
To know if the thrombus will resolve after anticoagulation will help to choose whether to initiate and/or continue it or not.</description><subject>Anticoagulants</subject><subject>Blood clots</subject><subject>Child</subject><subject>Children</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Occlusion</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Thrombosis</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Veins</subject><subject>Veins & arteries</subject><subject>Venous access</subject><subject>Venous Thrombosis - diagnostic imaging</subject><subject>Venous Thrombosis - drug therapy</subject><subject>Venous Thrombosis - etiology</subject><issn>0340-6199</issn><issn>1432-1076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU9rFTEUxYMo9ln9Ai4k4MbNaP5MJi_upFhbKBRKXYckc1-bOpM8czMPuvaLN6-vKrhwEQI5v3OSm0PIW84-csb0J2Ssl7xjoi1p1qpTz8iK91J0nOnhOVkx2bNu4MYckVeId6yZDF-_JEdSKqV6oVfk11XEH3TjQs0F6QgVyhxTTDc0QKrFTXQHKS9IXQiAe2IXA3QOMYfoKoztBLYNionW25JnnzEiLYB5WmrMiTYh3MZpLJA-U9eUWjJuIdS4A4p1Ge9fkxcbNyG8edqPyffTr9cnZ93F5bfzky8XXZBiqJ3yvfRSeGOkcG5Q2jMYhBm8N9KY4EBp5bznUoBYs9GL0Y9KSsl7ozUTII_Jh0PutuSfC2C1c8QA0-QStBGt6Ne6faiWrKHv_0Hv8lJSe50VSgijFRtUo8SBCm0kLLCx2xJnV-4tZ3ZfkT1UZFtF9rEiuze9e4pe_AzjH8vvThogDwA2Kd1A-Xv3f2IfAHF1nhA</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>García-Boyano, Miguel</creator><creator>Caballero-Caballero, José Manuel</creator><creator>García Fernández de Villalta, Marta</creator><creator>Gutiérrez Alvariño, Mar</creator><creator>Blanco Bañares, María Jesús</creator><creator>Climent Alcalá, Francisco José</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3717-4819</orcidid></search><sort><creationdate>20210601</creationdate><title>Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a retrospective study</title><author>García-Boyano, Miguel ; 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Current guidelines suggest anticoagulation for a maximum of 3 months in patients with provoked DVT if the provoking factor is resolved. To know if the thrombus will resolve after anticoagulant therapy will help to choose whether to initiate and/or continue this treatment or not. We did a retrospective study of 85 pediatric patients (45 girls, 40 boys) with CVAD-associated DVT to examine the risk factors associated with lack of thrombus resolution in the first 6 months after diagnosis. Sixty-two children had their thrombosis resolved after a median of 50 days (p25-p75 25–97) since diagnosis. In multivariate analysis, variables significantly associated with no resolution were total occlusion (OR 12.50, 95% CI 2.99–52.14,
p
=.001), location in upper extremity, head, and neck veins (OR 17.70, 95% CI 1.64–191.43,
p
=.018); collateral circulation in the first 45 days after diagnosis (OR 33.55, 95% CI 2.42–464.71,
p
=.009); and having between 0 and 3 prothrombotic risk factors at diagnosis (OR 6.20, 95% CI 1.21–31.75,
p
=.029).
Conclusion
: CVAD-associated DVT resolution in children in the first 6 months since diagnosis was significantly lower if the thrombosis was occlusive, if it was located in the upper extremity, head, and neck veins; if collateral circulation was seen on ultrasound in the first 45 days; and/or when the patient showed less prothrombotic risk factors at diagnosis.
What is Known:
•
The risk factors associated with central venous access device-associated deep vein thrombosis resolution have been hardly evaluated in children.
•
Current guidelines suggest anticoagulation for a maximum of 3 months in provoked vein thrombosis if the provoking factor is resolved.
What is New:
•
Thrombus resolution was lower if it was occlusive, located in the upper extremity veins, if collateral circulation was seen, and with less prothrombotic risk factors at diagnosis.
•
To know if the thrombus will resolve after anticoagulation will help to choose whether to initiate and/or continue it or not.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33555427</pmid><doi>10.1007/s00431-021-03985-5</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3717-4819</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Anticoagulants Blood clots Child Children Diagnosis Female Humans Male Medicine Medicine & Public Health Multivariate analysis Occlusion Original Article Patients Pediatrics Retrospective Studies Risk Factors Thrombosis Ultrasonography Ultrasound Veins Veins & arteries Venous access Venous Thrombosis - diagnostic imaging Venous Thrombosis - drug therapy Venous Thrombosis - etiology |
| title | Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a retrospective study |
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