Pulmonary embolism: which pediatric trauma patients are at risk?
Deep vein thrombosis and pulmonary embolism (DVT/PE) are rare in pediatric trauma patients, and guidelines for prophylaxis are scarce. The authors sought to identify subgroups of patients who may be at higher risk of developing DVT/PE. Case-control study of pediatric trauma patients with DVT/PE. Odd...
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| Veröffentlicht in: | Journal of pediatric surgery 2005, Vol.40 (1), p.124-127 |
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| creator | Truitt, Anne K. Sorrells, Donald L. Halvorson, Eric Starring, Jayne Kurkchubasche, Arlet G. Tracy, Thomas F. Luks, Francois I. |
| description | Deep vein thrombosis and pulmonary embolism (DVT/PE) are rare in pediatric trauma patients, and guidelines for prophylaxis are scarce. The authors sought to identify subgroups of patients who may be at higher risk of developing DVT/PE.
Case-control study of pediatric trauma patients with DVT/PE. Odds ratios (ORs) and confidence intervals (CIs) were calculated for known risk factors of PE using matched trauma controls (
χ
2 analysis).
A total of 3637 pediatric trauma patients was admitted over the last 7 years. Three patients developed DVT/PE (overall incidence, 0.08%). There were 2 girls and 1 boy, aged 15, 15, and 9 years, respectively. All 3 had an Injury Severity Score (ISS) ≥25 and an initial Glasgow Coma Score (GCS) ≤8. None of the known and potential risk factors significantly increased the OR for developing DVT/PE: age 9 years or older (OR, 3.6; CI, 0.4-26), presence of head injury (OR, 2.9; CI, 0.3-22), female sex (OR, 1.2; CI, 0.15-9.1), GCS ≤8 (OR, 9.2; CI, 0.9-230), except ISS ≥25 (OR, 82; CI, 7.6-2058). The OR for a combination of age and GCS was 106, and the OR for the 3 risk factors (age, ISS, GCS) common to all 3 patients was 114 (CI, 10-5000;
P < .001).
The overall incidence of DVT/PE in pediatric trauma patients is |
| doi_str_mv | 10.1016/j.jpedsurg.2004.09.017 |
| format | Article |
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Case-control study of pediatric trauma patients with DVT/PE. Odds ratios (ORs) and confidence intervals (CIs) were calculated for known risk factors of PE using matched trauma controls (
χ
2 analysis).
A total of 3637 pediatric trauma patients was admitted over the last 7 years. Three patients developed DVT/PE (overall incidence, 0.08%). There were 2 girls and 1 boy, aged 15, 15, and 9 years, respectively. All 3 had an Injury Severity Score (ISS) ≥25 and an initial Glasgow Coma Score (GCS) ≤8. None of the known and potential risk factors significantly increased the OR for developing DVT/PE: age 9 years or older (OR, 3.6; CI, 0.4-26), presence of head injury (OR, 2.9; CI, 0.3-22), female sex (OR, 1.2; CI, 0.15-9.1), GCS ≤8 (OR, 9.2; CI, 0.9-230), except ISS ≥25 (OR, 82; CI, 7.6-2058). The OR for a combination of age and GCS was 106, and the OR for the 3 risk factors (age, ISS, GCS) common to all 3 patients was 114 (CI, 10-5000;
P < .001).
The overall incidence of DVT/PE in pediatric trauma patients is <0.1% and routine prophylaxis is not recommended. Children aged 9 years or older with an initial GCS ≤8 and patients with an estimated ISS ≥25 may constitute a high-risk group in which prophylaxis could be considered.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/j.jpedsurg.2004.09.017</identifier><identifier>PMID: 15868571</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Anticoagulants - therapeutic use ; Case-Control Studies ; Child ; Confidence Intervals ; Female ; Humans ; Incidence ; Male ; Odds Ratio ; Pulmonary Embolism - epidemiology ; Pulmonary Embolism - etiology ; Pulmonary Embolism - prevention & control ; Rhode Island ; Risk Factors ; Trauma Severity Indices ; Venous Thrombosis - epidemiology ; Venous Thrombosis - etiology ; Venous Thrombosis - prevention & control ; Wounds and Injuries - complications</subject><ispartof>Journal of pediatric surgery, 2005, Vol.40 (1), p.124-127</ispartof><rights>2005 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-dd2806adc83b719537ef7c51d3485905aee0316f6ce862d3f275fc0a8f9ff143</citedby><cites>FETCH-LOGICAL-c366t-dd2806adc83b719537ef7c51d3485905aee0316f6ce862d3f275fc0a8f9ff143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022346804006207$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15868571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Truitt, Anne K.</creatorcontrib><creatorcontrib>Sorrells, Donald L.</creatorcontrib><creatorcontrib>Halvorson, Eric</creatorcontrib><creatorcontrib>Starring, Jayne</creatorcontrib><creatorcontrib>Kurkchubasche, Arlet G.</creatorcontrib><creatorcontrib>Tracy, Thomas F.</creatorcontrib><creatorcontrib>Luks, Francois I.</creatorcontrib><title>Pulmonary embolism: which pediatric trauma patients are at risk?</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>Deep vein thrombosis and pulmonary embolism (DVT/PE) are rare in pediatric trauma patients, and guidelines for prophylaxis are scarce. The authors sought to identify subgroups of patients who may be at higher risk of developing DVT/PE.
Case-control study of pediatric trauma patients with DVT/PE. Odds ratios (ORs) and confidence intervals (CIs) were calculated for known risk factors of PE using matched trauma controls (
χ
2 analysis).
A total of 3637 pediatric trauma patients was admitted over the last 7 years. Three patients developed DVT/PE (overall incidence, 0.08%). There were 2 girls and 1 boy, aged 15, 15, and 9 years, respectively. All 3 had an Injury Severity Score (ISS) ≥25 and an initial Glasgow Coma Score (GCS) ≤8. None of the known and potential risk factors significantly increased the OR for developing DVT/PE: age 9 years or older (OR, 3.6; CI, 0.4-26), presence of head injury (OR, 2.9; CI, 0.3-22), female sex (OR, 1.2; CI, 0.15-9.1), GCS ≤8 (OR, 9.2; CI, 0.9-230), except ISS ≥25 (OR, 82; CI, 7.6-2058). The OR for a combination of age and GCS was 106, and the OR for the 3 risk factors (age, ISS, GCS) common to all 3 patients was 114 (CI, 10-5000;
P < .001).
The overall incidence of DVT/PE in pediatric trauma patients is <0.1% and routine prophylaxis is not recommended. Children aged 9 years or older with an initial GCS ≤8 and patients with an estimated ISS ≥25 may constitute a high-risk group in which prophylaxis could be considered.</description><subject>Adolescent</subject><subject>Anticoagulants - therapeutic use</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Odds Ratio</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary Embolism - prevention & control</subject><subject>Rhode Island</subject><subject>Risk Factors</subject><subject>Trauma Severity Indices</subject><subject>Venous Thrombosis - epidemiology</subject><subject>Venous Thrombosis - etiology</subject><subject>Venous Thrombosis - prevention & control</subject><subject>Wounds and Injuries - complications</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtOwzAQRS0EoqXwC1VW7BLGcf0IG0CIl4QEi-4t1xlTl6QpdgLi73HVIpasRhrdh-4hZEqhoEDFxapYbbCOQ3grSoBZAVUBVB6QMeWM5hyYPCRjgLLM2UyoETmJcQWQ3kCPyYhyJRSXdEyuX4em7dYmfGfYLrrGx_Yy-1p6u8xSvjd98Dbrgxlak21M73Hdx8wEzEyfBR_fr07JkTNNxLP9nZD5_d389jF_fnl4ur15zi0Tos_rulQgTG0VW0hacSbRSctpzWaKV8ANIjAqnLCoRFkzV0ruLBjlKufojE3I-S52E7qPAWOvWx8tNo1ZYzdELaSsmCohCcVOaEMXY0CnN8G3aZ-moLfo9Er_otNbdBoqndAl43TfMCxarP9se1ZJcL0TYJr56THoaBMPmzAFtL2uO_9fxw8b2oN4</recordid><startdate>2005</startdate><enddate>2005</enddate><creator>Truitt, Anne K.</creator><creator>Sorrells, Donald L.</creator><creator>Halvorson, Eric</creator><creator>Starring, Jayne</creator><creator>Kurkchubasche, Arlet G.</creator><creator>Tracy, Thomas F.</creator><creator>Luks, Francois I.</creator><general>Elsevier Inc</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>7X8</scope></search><sort><creationdate>2005</creationdate><title>Pulmonary embolism: which pediatric trauma patients are at risk?</title><author>Truitt, Anne K. ; Sorrells, Donald L. ; Halvorson, Eric ; Starring, Jayne ; Kurkchubasche, Arlet G. ; Tracy, Thomas F. ; Luks, Francois I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-dd2806adc83b719537ef7c51d3485905aee0316f6ce862d3f275fc0a8f9ff143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Anticoagulants - therapeutic use</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Odds Ratio</topic><topic>Pulmonary Embolism - epidemiology</topic><topic>Pulmonary Embolism - etiology</topic><topic>Pulmonary Embolism - prevention & control</topic><topic>Rhode Island</topic><topic>Risk Factors</topic><topic>Trauma Severity Indices</topic><topic>Venous Thrombosis - epidemiology</topic><topic>Venous Thrombosis - etiology</topic><topic>Venous Thrombosis - prevention & control</topic><topic>Wounds and Injuries - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Truitt, Anne K.</creatorcontrib><creatorcontrib>Sorrells, Donald L.</creatorcontrib><creatorcontrib>Halvorson, Eric</creatorcontrib><creatorcontrib>Starring, Jayne</creatorcontrib><creatorcontrib>Kurkchubasche, Arlet G.</creatorcontrib><creatorcontrib>Tracy, Thomas F.</creatorcontrib><creatorcontrib>Luks, Francois I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Truitt, Anne K.</au><au>Sorrells, Donald L.</au><au>Halvorson, Eric</au><au>Starring, Jayne</au><au>Kurkchubasche, Arlet G.</au><au>Tracy, Thomas F.</au><au>Luks, Francois I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary embolism: which pediatric trauma patients are at risk?</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2005</date><risdate>2005</risdate><volume>40</volume><issue>1</issue><spage>124</spage><epage>127</epage><pages>124-127</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><abstract>Deep vein thrombosis and pulmonary embolism (DVT/PE) are rare in pediatric trauma patients, and guidelines for prophylaxis are scarce. The authors sought to identify subgroups of patients who may be at higher risk of developing DVT/PE.
Case-control study of pediatric trauma patients with DVT/PE. Odds ratios (ORs) and confidence intervals (CIs) were calculated for known risk factors of PE using matched trauma controls (
χ
2 analysis).
A total of 3637 pediatric trauma patients was admitted over the last 7 years. Three patients developed DVT/PE (overall incidence, 0.08%). There were 2 girls and 1 boy, aged 15, 15, and 9 years, respectively. All 3 had an Injury Severity Score (ISS) ≥25 and an initial Glasgow Coma Score (GCS) ≤8. None of the known and potential risk factors significantly increased the OR for developing DVT/PE: age 9 years or older (OR, 3.6; CI, 0.4-26), presence of head injury (OR, 2.9; CI, 0.3-22), female sex (OR, 1.2; CI, 0.15-9.1), GCS ≤8 (OR, 9.2; CI, 0.9-230), except ISS ≥25 (OR, 82; CI, 7.6-2058). The OR for a combination of age and GCS was 106, and the OR for the 3 risk factors (age, ISS, GCS) common to all 3 patients was 114 (CI, 10-5000;
P < .001).
The overall incidence of DVT/PE in pediatric trauma patients is <0.1% and routine prophylaxis is not recommended. Children aged 9 years or older with an initial GCS ≤8 and patients with an estimated ISS ≥25 may constitute a high-risk group in which prophylaxis could be considered.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15868571</pmid><doi>10.1016/j.jpedsurg.2004.09.017</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Anticoagulants - therapeutic use Case-Control Studies Child Confidence Intervals Female Humans Incidence Male Odds Ratio Pulmonary Embolism - epidemiology Pulmonary Embolism - etiology Pulmonary Embolism - prevention & control Rhode Island Risk Factors Trauma Severity Indices Venous Thrombosis - epidemiology Venous Thrombosis - etiology Venous Thrombosis - prevention & control Wounds and Injuries - complications |
| title | Pulmonary embolism: which pediatric trauma patients are at risk? |
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