ePrints

Clinical presentation and therapeutic management of venous thrombosis in young children: A retrospective analysis

Lookup NU author(s): Dr Tina Biss

Downloads

• Published version [.pdf]

Licence

This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2018 The Author(s). Background: Venous thromboembolism (VTE) in young children is not well documented. Methods: Clinicians from 12 institutions retrospectively evaluated the presentation, therapeutic management, and outcome of VTE in children younger than 2 years seen in 2011-2016. Feasibility of recruiting these children in EINSTEIN-Jr. phase III, a randomized trial evaluating rivaroxaban versus standard anticoagulation for VTE, was assessed. Results: We identified 346 children with VTE, of whom 227 (65.6%) had central venous catheter-related thrombosis (CVC-VTE), 119 (34.4%) had non-CVC-VTE, and 156 (45.1%) were younger than 1 month. Of the 309 children who received anticoagulant therapy, 86 (27.8%) had a short duration of therapy (i.e. < 6 weeks for CVC-VTE and < 3 months for non-CVC-VTE) and 17 (5.5%) had recurrent VTE during anticoagulation (n = 8, 2.6%) or shortly after its discontinuation (n = 9, 2.9%). A total of 37 (10.7%) children did not receive anticoagulant therapy and 4 (10.5%) had recurrent VTE. The average number of children aged < 0.5 years and 0.5-2 years who would have been considered for enrolment in EINSTEIN-Jr is approximately 1.0 and 0.9 per year per site, respectively. Conclusions: Young children with VTE most commonly have CVC-VTE and approximately one-tenth and one-fourth received no or only short durations of anticoagulant therapy, respectively. Recurrent VTE rates without anticoagulation, during anticoagulation or shortly after its discontinuation seem comparable to those observed in adults. Short and flexible treatment durations could potentially increase recruitment in EINSTEIN-Jr. phase III.

Publication metadata

Author(s): Chan A, Lensing AWA, Kubitza D, Brown G, Elorza D, Ybarra M, Halton J, Grunt S, Kenet G, Bonnet D, Santamaria A, Saracco P, Biss T, Climent F, Connor P, Palumbo J, Thelen K, Smith WT, Mason A, Adalbo I, Berkowitz SD, Hurst E, Van Kesteren J, Young G, Monagle P

Publication type: Article

Publication status: Published

Journal: Thrombosis Journal

Year: 2018

Volume: 16

Issue: 1

Online publication date: 01/11/2018

Acceptance date: 19/08/2018

Date deposited: 28/11/2018

ISSN (electronic): 1477-9560

Publisher: BioMed Central Ltd.

URL: https://doi.org/10.1186/s12959-018-0182-4

DOI: 10.1186/s12959-018-0182-4

Altmetrics

Share