TY - JOUR
T1 - Venous Thromboembolism in Children with Sickle Cell Disease
T2 - A Retrospective Cohort Study
AU - Woods, Gary M.
AU - Sharma, Ruchika
AU - Creary, Susan
AU - O'Brien, Sarah
AU - Stanek, Joseph
AU - Hor, Kan
AU - Young, Jennifer
AU - Dunn, Amy L.
AU - Kumar, Riten
N1 - Funding Information:
R.K. received the 2016 Mentored Research Award from the Hemostasis and Thrombosis Research Society (HTRS), which was supported by an educational grant from Bioverativ Therapeutics. The authors declare no conflicts of interest.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Objectives: To describe the cumulative incidence of venous thromboembolism (VTE) in children with sickle cell disease (SCD) followed at a single institution and report on the risk factors associated with VTE development. Study design: Charts for all patients with SCD, aged 0-21 years, followed at Nationwide Children's Hospital over a 6-year period (January 1, 2009, to January 31, 2015) were reviewed. Data on VTE diagnosis, sex, body mass index/weight-for-length, SCD genotype, SCD clinical complications, central venous catheter (CVC) placement, and thrombophilia testing were collected. Results: Cumulative incidence of VTE in children with SCD followed at a single tertiary care institution was found to be 2.9% (12/414). Nine of the 12 VTE were CVC-associated. On univariate analysis, hemoglobin SS genotype (OR 10.7, 95% CI 1.4-83.5), CVC presence (OR 34.4, 95% CI 8.9-134.6), central nervous system vasculopathy (OR 19.4, 95% CI 5.6-63.4), chronic transfusion therapy (OR 30.6, 95% CI 8.9-122.2), and older age (P =.03) were associated with VTE. However, presence of CVC was the only independent risk factor identified on multivariable logistic regression analysis (OR 33.8, 95% CI 8.7-130.9). Conclusion: In our institution, nearly 3% of children with SCD had a history of VTE. CVC is an independent predictor of VTE in children with SCD.
AB - Objectives: To describe the cumulative incidence of venous thromboembolism (VTE) in children with sickle cell disease (SCD) followed at a single institution and report on the risk factors associated with VTE development. Study design: Charts for all patients with SCD, aged 0-21 years, followed at Nationwide Children's Hospital over a 6-year period (January 1, 2009, to January 31, 2015) were reviewed. Data on VTE diagnosis, sex, body mass index/weight-for-length, SCD genotype, SCD clinical complications, central venous catheter (CVC) placement, and thrombophilia testing were collected. Results: Cumulative incidence of VTE in children with SCD followed at a single tertiary care institution was found to be 2.9% (12/414). Nine of the 12 VTE were CVC-associated. On univariate analysis, hemoglobin SS genotype (OR 10.7, 95% CI 1.4-83.5), CVC presence (OR 34.4, 95% CI 8.9-134.6), central nervous system vasculopathy (OR 19.4, 95% CI 5.6-63.4), chronic transfusion therapy (OR 30.6, 95% CI 8.9-122.2), and older age (P =.03) were associated with VTE. However, presence of CVC was the only independent risk factor identified on multivariable logistic regression analysis (OR 33.8, 95% CI 8.7-130.9). Conclusion: In our institution, nearly 3% of children with SCD had a history of VTE. CVC is an independent predictor of VTE in children with SCD.
KW - sickle cell disease
KW - venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85044538431&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044538431&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2018.01.073
DO - 10.1016/j.jpeds.2018.01.073
M3 - Article
C2 - 29605397
AN - SCOPUS:85044538431
SN - 0022-3476
VL - 197
SP - 186-190.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -