Tran M, et al. - The intention of the authors was to determine a sub-group of “venous thromboembolism (VTE)-rich” population among pediatric intensive care unit (PICU) children. Additionally, they contemplated the effect of VTE on morbidity and mortality. A prominent risk of developing VTE was noted among critically ill children with CVC. Detection of the above “VTE-rich” cohort could assist in the design of clinical trials targeting the prevention of VTE among hospitalized PICU children.

Methods

• Data was cumulated for children with a CVC and presence of a VTE, from a multicenter Virtual PICU Database, or VPS.
• The all cause mortality served as the primary outcome variable.
• The secondary outcome measure included prolonged mechanical ventilation.
• Additionally, the primary diagnoses and Pediatric risk of mortality 2 (PIM 2) score were recorded.

Results

• A total 158,299 PICU patients who had a CVC were identified, among whom 1,602 patients had VTE (103 per 10,000 PICU patients).
• Based on the multivariate analysis, an increased risk of VTE was unveiled in patients who were <1 year old (OR 1.48; 1.30-1.68), mechanically ventilated (OR 2.48; 2.07-2.98), had either a diagnostic (OR 2.32; 1.94-2.78) or therapeutic cardiac catheterization (OR 2.06; 1.66-2.55), PICC (OR 3.91; 3.50-4.37), and percutaneous CVC (OR 3.99; 3.48-4.61).
• It was noted that endocrinologic, immunologic, and gastrointestinal disorders were the primary diagnoses associated with VTE.
• Increased odds of mortality (OR 1.71; 1.47-2.00) were reported among PICU patients with CVC and VTE, after adjusting for factors associated with mortality, and fewer Ventilator Free Days (VFD) than patients without VTE.