Venous thromboembolism after trauma: When do children become adults?

Kyle J. Van Arendonk, Eric B. Schneider, Adil H. Haider, Paul Colombani, Fray Dylan Stewart, Elliott Haut

Research output: Contribution to journalArticle

Abstract

IMPORTANCE No national standardized guidelines exist to date for venous thromboembolism (VTE) prophylaxis after pediatric trauma. While the risk of VTE after trauma is generally lower for children than for adults, the precise age at which the risk of VTE increases is not clear. OBJECTIVE To identify the age at which the risk of VTE after trauma increases from the low rate seen in children toward the higher rate seen in adults. DESIGN, SETTING, AND PARTICIPANTS Multivariable logistic regression models were used to estimate the association between age and the odds of VTE when adjusting for other VTE risk factors. Participants included 402 329 patients 21 years or younger who were admitted following traumatic injury between January 1, 2008, and December 31, 2010, at US trauma centers participating in the National Trauma Data Bank. MAIN OUTCOMES AND MEASURES Diagnosis of VTE as a complication during hospital admission. RESULTS Venous thromboembolism was diagnosed in 1655 patients (0.4%). Those having VTE were more severely injured compared with those not having VTE and more frequently required critical care, blood transfusion, central line placement, mechanical ventilation, and surgery. The risk of VTE was low among younger patients, occurring in 0.1%of patients 12 years or younger, but increased to 0.3%in patients aged 13 to 15 years and to 0.8%in patients 16 years or older. These findings remained when adjusting for other factors, with patients aged 13 to 15 years (adjusted odds ratio, 1.96, 95%CI 1.53-2.52; P

Original languageEnglish (US)
Pages (from-to)1123-1130
Number of pages8
JournalJAMA Surgery
Volume148
Issue number12
DOIs
StatePublished - Dec 2013

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Venous Thromboembolism
Wounds and Injuries
Logistic Models
Trauma Centers
Critical Care
Artificial Respiration
Blood Transfusion
Odds Ratio
Databases
Guidelines
Pediatrics

ASJC Scopus subject areas

  • Surgery

Cite this

Van Arendonk, K. J., Schneider, E. B., Haider, A. H., Colombani, P., Stewart, F. D., & Haut, E. (2013). Venous thromboembolism after trauma: When do children become adults? JAMA Surgery, 148(12), 1123-1130. https://doi.org/10.1001/jamasurg.2013.3558

Venous thromboembolism after trauma : When do children become adults? / Van Arendonk, Kyle J.; Schneider, Eric B.; Haider, Adil H.; Colombani, Paul; Stewart, Fray Dylan; Haut, Elliott.

In: JAMA Surgery, Vol. 148, No. 12, 12.2013, p. 1123-1130.

Research output: Contribution to journalArticle

Van Arendonk, KJ, Schneider, EB, Haider, AH, Colombani, P, Stewart, FD & Haut, E 2013, 'Venous thromboembolism after trauma: When do children become adults?', JAMA Surgery, vol. 148, no. 12, pp. 1123-1130. https://doi.org/10.1001/jamasurg.2013.3558
Van Arendonk, Kyle J. ; Schneider, Eric B. ; Haider, Adil H. ; Colombani, Paul ; Stewart, Fray Dylan ; Haut, Elliott. / Venous thromboembolism after trauma : When do children become adults?. In: JAMA Surgery. 2013 ; Vol. 148, No. 12. pp. 1123-1130.
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