A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä

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




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

KustantajaAmerican Association of Neurological Surgeons

Julkaisuvuosi2023

JournalJournal of Neurosurgery: Pediatrics

Tietokannassa oleva lehden nimiJournal of neurosurgery. Pediatrics

Lehden akronyymiJ Neurosurg Pediatr

Vuosikerta32

Numero3

Aloitussivu285

Lopetussivu293

ISSN1933-0707

eISSN1933-0715

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

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

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/181393639


Tiivistelmä
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.


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