A multi-institutional registry of pediatric hospital-acquired thrombosis cases: The Children's Hospital-Acquired Thrombosis (CHAT) project

Julie Jaffray, Arash Mahajerin, Guy Young, Neil Goldenberg, Lingyun Ji, Richard Sposto, Amy Stillings, Emily Krava, Brian Branchford

Research output: Research - peer-reviewArticle

Abstract

Background Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. Objectives This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model. Methods A registry, which houses pertinent variables from HA-VTE subjects and non-HA-VTE controls, was created for the Children's Hospital-Acquired Thrombosis (CHAT) study. Specific variables from the registry associated with HA-VTE risk will be identified using multivariable regression to create a pediatric HA-VTE risk prediction model to be prospectively validated. Results Seven large pediatric institutions have entered over 600 HA-VTE subjects aged 0–21 years of age into the registry. Subjects showed a male predominance (57%), a median age of three years (IQR 0.3–13) and were most likely admitted to an intensive care unit (57%) at VTE diagnosis. Median time to HA-VTE was 10 days after admission. The most prevalent risk factors include central venous catheters (80%), surgery (43%), systemic steroids (31%), congenital heart disease (27%), infection (14%) and cancer (13%). Conclusions CHAT, with its creation of a risk prediction model with prospective validation using the CHAT registry, is a novel study design and will be the first step in identifying safe and effective strategies to decrease HA-VTE in children by helping define the highest risk population for initial, or more aggressive, thromboprophylaxis efforts.

LanguageEnglish (US)
Pages67-72
Number of pages6
JournalThrombosis Research
Volume161
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Fingerprint

Pediatric Hospitals
Venous Thromboembolism
Registries
Thrombosis
Pediatrics
Central Venous Catheters
Intensive Care Units
Heart Diseases
Cohort Studies
Steroids
Research Personnel
Infection
Population
Neoplasms

Keywords

  • Hospitals
  • Pediatric
  • Pediatrics
  • Risk assessment
  • Risk factors
  • Venous thromboembolism

ASJC Scopus subject areas

  • Hematology

Cite this

A multi-institutional registry of pediatric hospital-acquired thrombosis cases : The Children's Hospital-Acquired Thrombosis (CHAT) project. / Jaffray, Julie; Mahajerin, Arash; Young, Guy; Goldenberg, Neil; Ji, Lingyun; Sposto, Richard; Stillings, Amy; Krava, Emily; Branchford, Brian.

In: Thrombosis Research, Vol. 161, 01.01.2018, p. 67-72.

Research output: Research - peer-reviewArticle

Jaffray, Julie ; Mahajerin, Arash ; Young, Guy ; Goldenberg, Neil ; Ji, Lingyun ; Sposto, Richard ; Stillings, Amy ; Krava, Emily ; Branchford, Brian. / A multi-institutional registry of pediatric hospital-acquired thrombosis cases : The Children's Hospital-Acquired Thrombosis (CHAT) project. In: Thrombosis Research. 2018 ; Vol. 161. pp. 67-72
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abstract = "Background Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. Objectives This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model. Methods A registry, which houses pertinent variables from HA-VTE subjects and non-HA-VTE controls, was created for the Children's Hospital-Acquired Thrombosis (CHAT) study. Specific variables from the registry associated with HA-VTE risk will be identified using multivariable regression to create a pediatric HA-VTE risk prediction model to be prospectively validated. Results Seven large pediatric institutions have entered over 600 HA-VTE subjects aged 0–21 years of age into the registry. Subjects showed a male predominance (57%), a median age of three years (IQR 0.3–13) and were most likely admitted to an intensive care unit (57%) at VTE diagnosis. Median time to HA-VTE was 10 days after admission. The most prevalent risk factors include central venous catheters (80%), surgery (43%), systemic steroids (31%), congenital heart disease (27%), infection (14%) and cancer (13%). Conclusions CHAT, with its creation of a risk prediction model with prospective validation using the CHAT registry, is a novel study design and will be the first step in identifying safe and effective strategies to decrease HA-VTE in children by helping define the highest risk population for initial, or more aggressive, thromboprophylaxis efforts.",
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