Post-thrombotic syndrome in children: A systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors

Neil Goldenberg, Marco P. Donadini, Susan R. Kahn, Mark Crowther, Gili Kenet, Ulrike Nowak-Göttl, Marilyn J. Manco-Johnson

Research output: Contribution to journalArticle

Abstract

Background Post-thrombotic syndrome is a manifestation of chronic venous insufficiency following deep venous thrombosis. This systematic review was conducted to critically evaluate pediatric evidence on frequency of occurrence, validity of outcome measures, and prognostic indicators of post-thrombotic syndrome. Design and Methods A comprehensive literature search of original reports revealed 19 eligible studies, totaling 977 patients with upper/lower extremity deep venous thrombosis. Calculated weighted mean frequency of post-thrombotic syndrome was 26% (95% confidence interval: 23-28%) overall, and differed significantly by prospective/non-prospective analysis and use/non-use of a standardized outcome measure. Results Standardized post-thrombotic syndrome outcome measures included an adaptation of the Villalta scale, the Clinical-Etiologic-Anatomic-Pathologic classification, and the Manco-Johnson instrument. Data on validity were reported only for the Manco-Johnson instrument. No publications on post-thrombotic syndrome-related quality of life outcomes were identified. Candidate prognostic factors for post-thrombotic syndrome in prospective studies included use/non-use of thrombolysis and plasma levels of factor VIII activity and D-dimer. Conclusions Given that affected children must endure chronic sequelae for many decades, it is imperative that future collaborative pediatric prospective cohort studies and trials assess as key objectives and outcomes the incidence, severity, prognostic indicators, and health impact of post-thrombotic syndrome, using validated measures.

Original languageEnglish (US)
Pages (from-to)1952-1959
Number of pages8
JournalHaematologica
Volume95
Issue number11
DOIs
StatePublished - Nov 2010
Externally publishedYes

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Outcome Assessment (Health Care)
Venous Thrombosis
Prospective Studies
Pediatrics
Venous Insufficiency
Factor VIII
Publications
Lower Extremity
Cohort Studies
Quality of Life
Confidence Intervals
Incidence
Health

Keywords

  • Children
  • Deep venous thrombosis
  • Post-thrombotic syndrome
  • Systematic review

ASJC Scopus subject areas

  • Hematology

Cite this

Post-thrombotic syndrome in children : A systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors. / Goldenberg, Neil; Donadini, Marco P.; Kahn, Susan R.; Crowther, Mark; Kenet, Gili; Nowak-Göttl, Ulrike; Manco-Johnson, Marilyn J.

In: Haematologica, Vol. 95, No. 11, 11.2010, p. 1952-1959.

Research output: Contribution to journalArticle

Goldenberg, Neil ; Donadini, Marco P. ; Kahn, Susan R. ; Crowther, Mark ; Kenet, Gili ; Nowak-Göttl, Ulrike ; Manco-Johnson, Marilyn J. / Post-thrombotic syndrome in children : A systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors. In: Haematologica. 2010 ; Vol. 95, No. 11. pp. 1952-1959.
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