Abstract
The outcome for children with deep vein thrombosis (DVT) and pulmonary embolism (PE) is unknown. An understanding of morbidity and mortality of DVT/PE is crucial to the development of rational treatment protocols. The Canadian Childhood Thrombophilia Registry has followed 405 children aged 1 mo to 18 y with DVT/PE for a mean of 2.86 y (range, 2 wk to 6 y) to assess outcome. The all-cause mortality was 65 of 405 children (16%). Mortality directly attributable to DVT/PE occurred in nine children (2.2%), all of whom had central venous line–associated thrombosis. Morbidity was substantial, with 33 children (8.1%) having recurrent thrombosis, and 50 children (12.4%) having postphlebitic syndrome. Recurrent thrombosis and postphlebitic syndrome were more common in older children, although deaths occurred equally in all age groups. The incidence of recurrent thrombosis and postphlebitic syndrome are likely underestimated because of difficulties in diagnosis, especially in younger children. The significant mortality and morbidity found in our study supports the need for international multicenter randomized clinical trials to determine optimal prophylactic and therapeutic treatment for children with DVT/PE.
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Abbreviations
- DVT:
-
deep venous thrombosis
- PE:
-
pulmonary embolism
- PPS:
-
postphlebitic syndrome
- CVL:
-
central venous line
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Supported by a grant-in-aid from the Heart and Stroke Foundation of Ontario. Dr. Massicotte is a scientist with the Medical Research Council of Canada. Dr. Andrew is a career scientist with the Heart and Stroke Foundation of Canada.
Appendix
Appendix
The participating centers were British Columbia Children's Hospital (Vancouver, British Columbia), Alberta Children's Hospital (Calgary, Alberta), University Hospital (Edmonton, Alberta), University Hospital (Saskatoon, Saskatchewan), Children's Hospital (Winnipeg, Manitoba), Hamilton Health Sciences Centre—McMaster Campus (Hamilton, Ontario), Hospital for Sick Children (Toronto, Ontario), Children's Hospital of Western Ontario (London, Ontario), Children's Hospital of Eastern Ontario (Ottawa, Ontario), Hotel Dieu (Kingston, Ontario), Hopital Ste-Justine (Montreal, Quebec), Montreal Children's Hospital (Montreal, Quebec), Le Centre Hopital (Quebec City, Quebec), Izaak Walter Killam Children's Hospital (Halifax, Nova Scotia), and Janeway Child Health Centre (St. John's, Newfoundland).
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Monagle, P., Adams, M., Mahoney, M. et al. Outcome of Pediatric Thromboembolic Disease: A Report from the Canadian Childhood Thrombophilia Registry. Pediatr Res 47, 763–766 (2000). https://doi.org/10.1203/00006450-200006000-00013
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DOI: https://doi.org/10.1203/00006450-200006000-00013
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