Evaluation of venous thromboembolism risk factors reveals subtype heterogenicity in children with central venous catheters: a multicenter study from the Children's Hospital Acquired Thrombosis consortium.

Creator(s)

Julie Jaffray
Maua Mosha
Brian Branchford
Neil A. Goldenberg
Michael Silvey, Children's Mercy HospitalFollow
Stacy E. Croteau
John H. Fargo
James D. Cooper
Nihal Bakeer
Amy Stillings
Emily Krava
Guy Young
Ernest K. Amankwah

Document Type

Article

Publication Date

9-2023

Identifier

DOI: 10.1016/j.jtha.2023.03.045

Abstract

BACKGROUND: Acutely ill and medically complex children frequently rely on central venous catheters (CVCs) to provide life-sustaining treatment. Unfortunately, catheter-related thrombosis (CRT) is a serious and common complication. Little is known why some with a CVC develop CRT and others develop venous thromboembolism unrelated to the CVC (non-CRT).

OBJECTIVES: The aim of this study was to identify factors associated with CRT in children with hospital-acquired venous thromboembolism (HA-VTE).

METHODS: This case-case study included participants in the Children's Hospital Acquired Thrombosis Registry with HA-VTE and CVC aged 0 to 21 years from 8 US children's hospitals. Participants were excluded if they developed HA-VTE prior to CVC insertion or if the CVC insertion date was unknown. Logistic regression models were used to assess associations between clinical factors and CRT status.

RESULTS: There were 1144 participants with HA-VTE who had a CVC. CRT developed in 833 participants, and 311 developed non-CRT. Multivariable analysis showed increased odds of CRT (compared with non-CRT) in participants with peripherally inserted central catheters (odds ratio [OR], 3.80; 95% CI, 2.04-7.10; p < .001), CVCs inserted in the femoral vein (OR, 4.45; 95% CI, 1.70-11.65; p = .002), multiple CVCs (OR, 1.42; 95% CI, 1.18-1.71; p < .001), and CVC malfunction (OR, 3.30; 95% CI, 1.80-6.03; p < .001).

CONCLUSION: The findings of this study provide new insights on risk factor differences between CRT and non-CRT. Prevention efforts should be directed at modifying the type of CVC, insertion location, and/or number of CVCs placed, if possible, to decrease the incidence of CRT.

Journal Title

Journal of thrombosis and haemostasis : JTH

Volume

21

Issue

9

First Page

2441

Last Page

2450

MeSH Keywords

Humans; Child; Central Venous Catheters; Venous Thromboembolism; Risk Factors; Thrombosis; Hospitals; Catheterization, Central Venous

Keywords

central venous catheter; child; risk factor; thrombosis; venous thromboembolism

Comments

Erratum in

• Corrigendum to 'Evaluation of Venous Thromboembolism Risk Factors Reveals Subtype Heterogenicity in Children with Central Venous Catheters: A Multi-Center Study from the CHAT Consortium' [Journal of Thrombosis and Haemostasis 21/9 (2023) 2441 - 2450]. Jaffray J, Mosha M, Branchford B, Goldenberg NA, Silvey M, Croteau SE, Fargo JH, Cooper JD, Bakeer N, Stillings A, Krava E, Young G, Amankwah EK.J Thromb Haemost. 2023 Dec;21(12):3658. doi: 10.1016/j.jtha.2023.09.005. Epub 2023 Sep 21.PMID: 37741798 No abstract available.

Recommended Citation

Jaffray J, Mosha M, Branchford B, et al. Evaluation of venous thromboembolism risk factors reveals subtype heterogenicity in children with central venous catheters: a multicenter study from the Children's Hospital Acquired Thrombosis consortium. J Thromb Haemost. 2023;21(9):2441-2450. doi:10.1016/j.jtha.2023.03.045