Presenter Status
Resident/Psychology Intern
Abstract Type
Research
Primary Mentor
Shannon Carpenter, MD MS
Start Date
14-5-2025 11:30 AM
End Date
14-5-2025 1:30 PM
Presentation Type
Poster Presentation
Description
Background: Hospital-acquired thrombosis remains a significant concern in pediatric care, contributing to morbidity and extended hospital stays. At Children’s Mercy, a dedicated inpatient coagulation consultation service has existed for many years. Efforts have been made to implement prophylactic measures aimed at reducing the incidence of hospital-acquired thrombosis. With the recent COVID pandemic we saw an influx in prophylactic anticoagulation due to recommended guidelines.
Objectives: To characterize the impact increased efforts in thromboprophylaxis during and after the COVID-19 pandemic on care delivery and the development of thrombosis among pediatric hospitalized patients.
Methods: This retrospective review included all pediatric inpatients with a coagulation consultation between 2013 and 2023. Data collected included consultation details such as indication for consultation, patient age at time of consult, patient gender, and inpatient service requesting the consultation. Linear spline models were used to estimate the change in thromboprophylaxis and thrombosis consults over time, an how these aligned with the implementation of preventative strategies. Trends in consultations frequencies were quantified by inpatient service in order to assess which service(s) contributed to any observable changes in thromboprophylaxis consultations.
Results: From 2013-2023 3051 consults were seen by the inpatient coagulation consultation service. During that period, we noted an increase in the number of consults for thromboprophylaxis (10.4% in 2013 to 56.8% in 2023), in conjunction with COVID and MISC recommendations. Concomitantly, consults for thrombosis treatment declined (58.3% in 2013 to 24.5% in 2023). Other consult request indications stayed relatively stable. The overall number of consults increased significantly during the pandemic, and have since declined, though not to pre-pandemic levels. Increases in consults for thromboprophylaxis were most pronounced for patients seen in the PICU/MICU/SICU and General Pediatrics medical services.
Conclusion: Increased use of inpatient prophylactic anticoagulation was associated with decreased pediatric hospital-acquired thrombotic events within our center. Prophylactic anticoagulation should be considered in the pediatric inpatient setting in high-risk patients. Increased recommendations for thromboprophylaxis during the COVID pandemic may have led to more awareness and comfort for anticoagulation among consulting services which resulted in an overall increased uptake of the practice. Further research is required to determine if more aggressive anticoagulation recommendations would have a continued impact on hospital acquired thrombosis rates.
Included in
Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Science and Mathematics Education Commons
Patterns and Growth of a Dedicated Pediatric Coagulation Consult Service in a Freestanding Children's Hospital
Background: Hospital-acquired thrombosis remains a significant concern in pediatric care, contributing to morbidity and extended hospital stays. At Children’s Mercy, a dedicated inpatient coagulation consultation service has existed for many years. Efforts have been made to implement prophylactic measures aimed at reducing the incidence of hospital-acquired thrombosis. With the recent COVID pandemic we saw an influx in prophylactic anticoagulation due to recommended guidelines.
Objectives: To characterize the impact increased efforts in thromboprophylaxis during and after the COVID-19 pandemic on care delivery and the development of thrombosis among pediatric hospitalized patients.
Methods: This retrospective review included all pediatric inpatients with a coagulation consultation between 2013 and 2023. Data collected included consultation details such as indication for consultation, patient age at time of consult, patient gender, and inpatient service requesting the consultation. Linear spline models were used to estimate the change in thromboprophylaxis and thrombosis consults over time, an how these aligned with the implementation of preventative strategies. Trends in consultations frequencies were quantified by inpatient service in order to assess which service(s) contributed to any observable changes in thromboprophylaxis consultations.
Results: From 2013-2023 3051 consults were seen by the inpatient coagulation consultation service. During that period, we noted an increase in the number of consults for thromboprophylaxis (10.4% in 2013 to 56.8% in 2023), in conjunction with COVID and MISC recommendations. Concomitantly, consults for thrombosis treatment declined (58.3% in 2013 to 24.5% in 2023). Other consult request indications stayed relatively stable. The overall number of consults increased significantly during the pandemic, and have since declined, though not to pre-pandemic levels. Increases in consults for thromboprophylaxis were most pronounced for patients seen in the PICU/MICU/SICU and General Pediatrics medical services.
Conclusion: Increased use of inpatient prophylactic anticoagulation was associated with decreased pediatric hospital-acquired thrombotic events within our center. Prophylactic anticoagulation should be considered in the pediatric inpatient setting in high-risk patients. Increased recommendations for thromboprophylaxis during the COVID pandemic may have led to more awareness and comfort for anticoagulation among consulting services which resulted in an overall increased uptake of the practice. Further research is required to determine if more aggressive anticoagulation recommendations would have a continued impact on hospital acquired thrombosis rates.
