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.
| Language | English (US) |
|---|---|
| Pages | 67-72 |
| Number of pages | 6 |
| Journal | Thrombosis Research |
| Volume | 161 |
| DOIs | |
| State | Published - Jan 1 2018 |
| Externally published | Yes |
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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: Contribution to journal › Article
}
TY - JOUR
T1 - A multi-institutional registry of pediatric hospital-acquired thrombosis cases
T2 - Thrombosis Research
AU - Jaffray,Julie
AU - Mahajerin,Arash
AU - Young,Guy
AU - Goldenberg,Neil
AU - Ji,Lingyun
AU - Sposto,Richard
AU - Stillings,Amy
AU - Krava,Emily
AU - Branchford,Brian
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Hospitals
KW - Pediatric
KW - Pediatrics
KW - Risk assessment
KW - Risk factors
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85036495249&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85036495249&partnerID=8YFLogxK
U2 - 10.1016/j.thromres.2017.11.019
DO - 10.1016/j.thromres.2017.11.019
M3 - Article
VL - 161
SP - 67
EP - 72
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
ER -