Risk factors for radiologically confirmed VTE in hospitalized pediatric patientsless than 1 year of age

Abstract

Specific Aims Healthcare providers at Phoenix Children's Hospital (PCH) perceived an increase in rates of venous thromboembolism (VTE) in neonates and infants. This study aimed to identify the rate of VTE at PCH and compare to other pediatric institutions. Secondarily this study aimed to identify risk factors for VTE for all patients with central venous catheters at PCH. Methods An IRB approved retrospective chart review including inpatients < 1 year of age who underwent CVC placement or developed VTE was conducted. Patient demographics, characteristics of CVC, and known co-morbidities and risk variables were collected along with rates of VTE for infants < 1 year of age Pediatric Health Information System (PHIS) database for comparison. A Chi2 Test was used for comparison of VTE rates and multivariate logistic regression for risk factors/ characteristics of CVC analysis. Main Results The VTE rate was found to be 1.3257 per 1000 patient days, which was higher than 37 of 52 centers. In 100% of VTE cases a CVC was present. Presence of congenital heart disease(CHD) was found in 56% of cases with a significantly increased risk of VTE (OR=2.718, 95% CI: 1.12-6.52). Analysis of the size of CVC related to VTE demonstrated CVCs ? 4 French were associated with an increased frequency of VTE compared to CVCs ? 3 French (OR=19.2, 95% CI: 2.1-3.8). Conclusions The rate of VTE for this patient population warrants further attention and venous diameter measurements need to be performed and documented.