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Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events

BACKGROUND: Although less common in adults, venous thromboembolism (VTE) in children is a highly morbid, preventable adverse event. While VTE has been well studied among pediatric hospitalized and trauma patients, limited work has been done to examine postoperative VTE in children undergoing surgery...

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Autores principales: Mets, Elbert Johann, McLynn, Ryan Patrick, Grauer, Jonathan Newman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716836/
https://www.ncbi.nlm.nih.gov/pubmed/36474866
http://dx.doi.org/10.1136/wjps-2019-000084
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author Mets, Elbert Johann
McLynn, Ryan Patrick
Grauer, Jonathan Newman
author_facet Mets, Elbert Johann
McLynn, Ryan Patrick
Grauer, Jonathan Newman
author_sort Mets, Elbert Johann
collection PubMed
description BACKGROUND: Although less common in adults, venous thromboembolism (VTE) in children is a highly morbid, preventable adverse event. While VTE has been well studied among pediatric hospitalized and trauma patients, limited work has been done to examine postoperative VTE in children undergoing surgery. METHODS: Using data from National Surgical Quality Improvement Project Pediatric database (NSQIP-P) from 2012 to 2016, a retrospective cohort analysis was performed to determine the incidence of, and risk factors for, VTE in children undergoing surgery. Additionally, the relationships between VTE and other postoperative adverse outcomes were evaluated. RESULTS: Of 361 384 pediatric surgical patients, 378 (0.10%) were identified as experiencing postoperative VTE. After controlling for patient and surgical factors, we found that American Society of Anesthesiologists (ASA) class of II or greater, aged 16–18 years, non-elective surgery, general surgery (compared with several other surgical specialties), cardiothoracic surgery (compared with general surgery) and longer operative time were significantly associated with VTE in pediatric patients (p<0.001 for each comparison). Furthermore, a majority of adverse events were found to be associated with increased risk of subsequent VTE (p<0.001). CONCLUSION: In a large pediatric surgical population, an incidence of postoperative VTE of 0.10% was observed. Defined patient and surgical factors, and perioperative adverse events were found to be associated with such VTE events.
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spelling pubmed-97168362022-12-05 Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events Mets, Elbert Johann McLynn, Ryan Patrick Grauer, Jonathan Newman World J Pediatr Surg Original Research BACKGROUND: Although less common in adults, venous thromboembolism (VTE) in children is a highly morbid, preventable adverse event. While VTE has been well studied among pediatric hospitalized and trauma patients, limited work has been done to examine postoperative VTE in children undergoing surgery. METHODS: Using data from National Surgical Quality Improvement Project Pediatric database (NSQIP-P) from 2012 to 2016, a retrospective cohort analysis was performed to determine the incidence of, and risk factors for, VTE in children undergoing surgery. Additionally, the relationships between VTE and other postoperative adverse outcomes were evaluated. RESULTS: Of 361 384 pediatric surgical patients, 378 (0.10%) were identified as experiencing postoperative VTE. After controlling for patient and surgical factors, we found that American Society of Anesthesiologists (ASA) class of II or greater, aged 16–18 years, non-elective surgery, general surgery (compared with several other surgical specialties), cardiothoracic surgery (compared with general surgery) and longer operative time were significantly associated with VTE in pediatric patients (p<0.001 for each comparison). Furthermore, a majority of adverse events were found to be associated with increased risk of subsequent VTE (p<0.001). CONCLUSION: In a large pediatric surgical population, an incidence of postoperative VTE of 0.10% was observed. Defined patient and surgical factors, and perioperative adverse events were found to be associated with such VTE events. BMJ Publishing Group 2020-04-14 /pmc/articles/PMC9716836/ /pubmed/36474866 http://dx.doi.org/10.1136/wjps-2019-000084 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Mets, Elbert Johann
McLynn, Ryan Patrick
Grauer, Jonathan Newman
Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
title Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
title_full Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
title_fullStr Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
title_full_unstemmed Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
title_short Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
title_sort venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716836/
https://www.ncbi.nlm.nih.gov/pubmed/36474866
http://dx.doi.org/10.1136/wjps-2019-000084
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