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10.3324/haematol.2015.123455

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suck abstract from ncbi


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pmid26001789
      Haematologica 2015 ; 100 (8 ): 1045-50
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  • Hospital-associated venous thromboembolism in pediatrics: a systematic review and meta-analysis of risk factors and risk-assessment models #MMPMID26001789
  • Mahajerin A ; Branchford BR ; Amankwah EK ; Raffini L ; Chalmers E ; van Ommen CH ; Goldenberg NA
  • Haematologica 2015[Aug]; 100 (8 ): 1045-50 PMID26001789 show ga
  • Hospital-associated venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is increasing in pediatric centers. The objective of this work was to systematically review literature on pediatric hospital-acquired venous thromboembolism risk factors and risk-assessment models, to inform future prevention research. We conducted a literature search on pediatric venous thromboembolism risk via PubMed (1946-2014) and Embase (1980-2014). Data on risk factors and risk-assessment models were extracted from case-control studies, while prevalence data on clinical characteristics were obtained from registries, large (n>40) retrospective case series, and cohort studies. Meta-analyses were conducted for risk factors or clinical characteristics reported in at least three studies. Heterogeneity among studies was assessed with the Cochran Q test and quantified by the I(2) statistic. From 394 initial articles, 60 met the final inclusion criteria (20 case-control studies and 40 registries/large case series/cohort studies). Significant risk factors among case-control studies were: intensive care unit stay (OR: 2.14, 95% CI: 1.97-2.32); central venous catheter (OR: 2.12, 95% CI: 2.00-2.25); mechanical ventilation (OR: 1.56, 95%CI: 1.42-1.72); and length of stay in hospital (per each additional day, OR: 1.03, 95% CI: 1.03-1.03). Three studies developed/applied risk-assessment models from a combination of these risk factors. Fourteen significant clinical characteristics were identified through non-case-control studies. This meta-analysis confirms central venous catheter, intensive care unit stay, mechanical ventilation, and length of stay as risk factors. A few pediatric hospital-acquired venous thromboembolism risk scores have emerged employing these factors. Prospective validation is necessary to inform risk-stratified prevention trials.
  • |*Iatrogenic Disease [MESH]
  • |*Pediatrics [MESH]
  • |Case-Control Studies [MESH]
  • |Child [MESH]
  • |Hospital Mortality [MESH]
  • |Humans [MESH]
  • |Incidence [MESH]
  • |Odds Ratio [MESH]
  • |Prevalence [MESH]
  • |Risk Assessment [MESH]
  • |Risk Factors [MESH]


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