Venous thromboembolism risk among pediatric patients with traumatic brain injury: a nationwide study of 44,128 patients




Hoffmann Ildiko, Lewis Erin R, Marini Corrado, McNelis John, Viswanathan Shankar, Posti Jussi P, Lieb David A, Lowery Wilson Michael

PublisherAmerican Association of Neurological Surgeons

2023

Journal of Neurosurgery: Pediatrics

Journal of neurosurgery. Pediatrics

J Neurosurg Pediatr

32

3

285

293

1933-0707

1933-0715

DOIhttps://doi.org/10.3171/2023.4.PEDS23102

https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/32/3/article-p285.xml

https://research.utu.fi/converis/portal/detail/Publication/181393639



OBJECTIVE

Venous thromboembolism (VTE) chemoprophylaxis in pediatric patients with traumatic brain injury (TBI) requires balancing the risk of progression of intracranial bleeding versus the risk of VTE. The identification of VTE risk factors requires analysis of a very large data set. This case-control study aimed to identify VTE risk factors in pediatric patients with TBI in order to develop a TBI-specific association model that can be used for VTE risk stratification in this population.

METHODS

The study included patients (aged 1–17 years) from the 2013–2019 US National Trauma Data Bank who were admitted for TBI in order to identify risk factors for VTE. Stepwise logistic regression was used to develop an association model.

RESULTS

Of 44,128 study participants, 257 (0.58%) developed VTE. Risk factors associated with VTE included age (OR 1.045, 95% CI 1.010–1.080), body mass index (OR 1.034, 95% CI 1.013–1.055), Injury Severity Score (OR 1.049, 95% CI 1.039–1.059), blood product administration (OR 1.436, 95% CI 1.008–2.046), presence of a central venous catheter (OR 3.333, 95% CI 2.431–4.571), and development of ventilator-associated pneumonia (OR 3.650, 95% CI 2.469–5.396). Based on this model, the predicted VTE risk in pediatric patients with TBI ranged from 0% to 16.8%.

CONCLUSIONS

A model that includes age, body mass index, Injury Severity Score, blood transfusion, use of a central venous catheter, and ventilator-associated pneumonia can help to risk stratify pediatric patients with TBI from the standpoint of implementation of VTE chemoprophylaxis.


Last updated on 2025-27-03 at 22:05