Outcome of pediatric thromboembolic disease : A report from the Canadian Childhood thrombophilia Registry

• Published in: Pediatric research Vol. 47; no. 6; pp. 763 - 766
• Main Authors: MONAGLE, P, ADAMS, M, HALTON, J, ISRAELS, S, JARDINE, L, LEAKER, M, MCCUSKER, P, SILVA, M, WU, J, ANDERSON, R, ANDREW, M, MASSICOTTE, M. P, MAHONEY, M, ALI, K, BARNARD, D, BERNSTEIN, M, BRISSON, L, DAVID, M, DESAI, S, SCULLY, M.-F
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.06.2000
• Subjects: Adolescent; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Child; Child, Preschool; Cohort Studies; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Humans; Infant; Infant, Newborn; Medical sciences; Recurrence; Registries; Thromboembolism - etiology; Thromboembolism - mortality; Thromboembolism - physiopathology; Treatment Outcome; Human; Relapse; Prognosis; Respiratory disease; Mortality; Cardiovascular disease; Infant; Thrombosis; Morbidity; Venous disease; Vascular disease; Pulmonary embolism; Cohort study; Adolescent; Complication; Deep vein; Thromboembolism; Child
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1203/00006450-200006000-00013

The outcome for children with deep vein thrombosis (DVT) and pulmonary embolism (PE) is unknown. An understanding of morbidity and mortality of DVT/PE is crucial to the development of rational treatment protocols. The Canadian Childhood Thrombophilia Registry has followed 405 children aged 1 mo to 18 y with DVT/PE for a mean of 2.86 y (range, 2 wk to 6 y) to assess outcome. The all-cause mortality was 65 of 405 children (16%). Mortality directly attributable to DVT/PE occurred in nine children (2.2%), all of whom had central venous line-associated thrombosis. Morbidity was substantial, with 33 children (8.1%) having recurrent thrombosis, and 50 children (12.4%) having postphlebitic syndrome. Recurrent thrombosis and postphlebitic syndrome were more common in older children, although deaths occurred equally in all age groups. The incidence of recurrent thrombosis and postphlebitic syndrome are likely underestimated because of difficulties in diagnosis, especially in younger children. The significant mortality and morbidity found in our study supports the need for international multicenter randomized clinical trials to determine optimal prophylactic and therapeutic treatment for children with DVT/PE.