Can thrombophilia predict recurrent catheter-related deep vein thrombosis in children?
| العنوان: | Can thrombophilia predict recurrent catheter-related deep vein thrombosis in children? |
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| المؤلفون: | M. Laura Avila, Nour Amiri, Peter Krol, Katherine Barron, Sanja Stanojevic, Leonardo R. Brandão, Natasha Yue, Suzan Williams, Trang T. Vu |
| المصدر: | Blood. 131:2712-2719 |
| بيانات النشر: | American Society of Hematology, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Catheters, Adolescent, medicine.drug_class, Deep vein, Immunology, 030204 cardiovascular system & hematology, Thrombophilia, Biochemistry, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine, Humans, Cumulative incidence, Child, Retrospective Studies, Venous Thrombosis, Catheter insertion, business.industry, Incidence, Anticoagulant, Age Factors, Anticoagulants, Infant, Cell Biology, Hematology, Prognosis, medicine.disease, Thrombosis, Confidence interval, Surgery, Catheter, medicine.anatomical_structure, Child, Preschool, 030220 oncology & carcinogenesis, Female, business |
| الوصف: | The role of thrombophilia testing in predicting catheter-related deep vein thrombosis (DVT) after an incident (ie, first) catheter-related DVT in children remains unclear. The present study investigated the association between thrombophilia and recurrent catheter-related DVT. Children with thrombophilia testing, performed according to the clinician's judgment and the family's preference, and a history of objectively confirmed catheter-related DVT were included in the study. Recurrent catheter-related DVT after placement of a new catheter was the main outcome. Thrombophilia was classified as minor, major, or none. Analysis was conducted using mixed effect logistic regression. A total of 245 patients had 1,365 catheters inserted; 941 of these catheters were placed after the incident catheter-related DVT. Anticoagulants as treatment or prophylaxis were administered in 78.1% of inserted catheters for at least 50% of the time they were in place. Minor thrombophilia was found in 12.7% of patients, whereas major thrombophilia was seen in 8.2% of children. The incidence rate of recurrent events was 0.23/100 catheter-days (95% confidence interval, 0.19-0.28 catheter-days); 34.3% (95% confidence interval, 28.6%-40.0%) of patients requiring a new catheter after their incident thrombotic event had at least 1 recurrent event. The incidence proportion of bleeding complications was 4.6/100 patients receiving anticoagulation. Young age of the patient at the time of catheter insertion and lack of administration of treatment or prophylactic doses of anticoagulant were predictive of recurrent events. In contrast, thrombophilia was not predictive of recurrent catheter-related DVT during subsequent catheter insertions among tested patients. Our findings suggest that thrombophilia testing to predict recurrence in these patients may be unnecessary. |
| تدمد: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood-2017-10-811216 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b27236585e4a636e6bf9954b2994c85f https://doi.org/10.1182/blood-2017-10-811216 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b27236585e4a636e6bf9954b2994c85f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15280020 00064971 |
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| DOI: | 10.1182/blood-2017-10-811216 |