Sathya-Prasad Burjonrappa: Pediatric Trauma and Deep Venous Thrombosis
Sathya-Prasad Burjonrappa, Professor of Surgery at Rutgers Robert Wood Johnson Medical School, shared a post on LinkedIn:
“Reassessing Pediatric Trauma Deep Venous Thrombosis Incidence and Risk Factors
Sathyaprasad Burjonrappa, MD, MS, MBA, FRCS (Ed), FACS, Blane Soper, BS
Introduction: Recent literature reports deep venous thrombosis (DVT) incidence in pediatric trauma patients as 0.11%.
Early transfusion, lower-extremity fracture, and prolonged immobilization increase DVT risk.
Guidelines recommend prophylactic anticoagulation in children 15 years of age or older or post-pubescent children with an Injury Severity Score greater than 25.
This study aims to reassess pediatric trauma DVT incidence and evaluate other risk factors.
Methods: Overall pediatric DVT incidence was calculated in the National Trauma Data Bank (NTDB) from 2021 to 2023, and stratified by age groups.
Potential numerical and categorical DVT risk factors were studied using logistic regressions and chi-square analyses.
Results: Pediatric trauma DVT incidence was 0.14% across 431,838 patients and stable over time (0.15% in 2021, 0.13% in 2022, and 0.14% in 2023).
Teenage incidence was highest (0.27%) compared with younger children (0.03-0.04%).
Asian (p equals .038) and White (p less than .001) race were associated with lower DVT frequency, whereas Black (p less than .001) and Pacific Islander (p equals 0.005) race, as well as male sex (p less than .001), were associated with higher frequency.
Increasing ISS (odds ratio [OR] 1.082), age (OR 1.235), BMI (OR 1.004), whole blood transfusion within 4 hours (OR 1.0004), ICU length of stay (OR 1.058), ventilator days (OR 1.033), and time to VTE prophylaxis (OR 1.106) were significantly associated with DVT.
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