TY - JOUR
T1 - Venous thromboembolism in children with cystic fibrosis
T2 - Retrospective incidence and intrapopulation risk factors
AU - Knight-Perry, Jessica
AU - Branchford, Brian R.
AU - Thornhill, Dianne
AU - Martiniano, Stacey L.
AU - Sagel, Scott D.
AU - Wang, Michael
N1 - Funding Information:
Supported by NIH /NCATS Colorado CTSA Grant Number UL1 TR001082-04 . Contents are the authors' sole responsibility and do not necessarily represent official NIH views.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/10
Y1 - 2017/10
N2 - Introduction Pediatric venous thromboembolism (VTE) is a rare but serious medical condition. Cystic fibrosis (CF) is a risk for recurrent pediatric VTE and has potential thrombophilic tendency. However, much remains unknown, including incidence and intrapopulation risk factors. Methods A retrospective cohort of pediatric CF patients followed at Children's Hospital Colorado from January 1st 2003 through May 20th 2016 was examined. Cases were identified by informatics and validated manually. Data on CF severity, co-morbidities and treatment, central venous catheter (CVC) use, and thrombophilia were obtained from an institutional CF database and chart review. Results Nineteen VTE occurred in 458 participants followed for 3595 person-years, yielding an incidence rate of 53 VTE per 10,000 children with CF. VTE cases had additional co-morbidities including CF-related diabetes (p = 0.002) and sinus disease (p = 0.04), more total admissions (p < 0.001), admit days (p < 0.001), positive respiratory cultures (p < 0.001), pseudomonas infections (p < 0.001), steroid courses (p = 0.001), and total CVC days (PICC p = 0.03, port p = 0.007). On univariate analysis, older age (RR 1.162, p = 0.007), sinus disease (RR 2.62, p = 0.05), longer hospital stay (RR 1.03, p < 0.001), higher ESR (RR 1.02, p = 0.03) and CRP (RR 1.07, p = 0.007), and an absence of systemic steroids (RR 0.19, p = 0.004) increased the risk of VTE. Conclusions In this cohort, children with CF had a higher incidence of VTE when compared to the previously reported incidence in the overall pediatric population at Children's Hospital Colorado. Overall, those with VTE had a greater disease burden and older age, sinus disease, longer hospitalization and increased inflammation were VTE risk factors.
AB - Introduction Pediatric venous thromboembolism (VTE) is a rare but serious medical condition. Cystic fibrosis (CF) is a risk for recurrent pediatric VTE and has potential thrombophilic tendency. However, much remains unknown, including incidence and intrapopulation risk factors. Methods A retrospective cohort of pediatric CF patients followed at Children's Hospital Colorado from January 1st 2003 through May 20th 2016 was examined. Cases were identified by informatics and validated manually. Data on CF severity, co-morbidities and treatment, central venous catheter (CVC) use, and thrombophilia were obtained from an institutional CF database and chart review. Results Nineteen VTE occurred in 458 participants followed for 3595 person-years, yielding an incidence rate of 53 VTE per 10,000 children with CF. VTE cases had additional co-morbidities including CF-related diabetes (p = 0.002) and sinus disease (p = 0.04), more total admissions (p < 0.001), admit days (p < 0.001), positive respiratory cultures (p < 0.001), pseudomonas infections (p < 0.001), steroid courses (p = 0.001), and total CVC days (PICC p = 0.03, port p = 0.007). On univariate analysis, older age (RR 1.162, p = 0.007), sinus disease (RR 2.62, p = 0.05), longer hospital stay (RR 1.03, p < 0.001), higher ESR (RR 1.02, p = 0.03) and CRP (RR 1.07, p = 0.007), and an absence of systemic steroids (RR 0.19, p = 0.004) increased the risk of VTE. Conclusions In this cohort, children with CF had a higher incidence of VTE when compared to the previously reported incidence in the overall pediatric population at Children's Hospital Colorado. Overall, those with VTE had a greater disease burden and older age, sinus disease, longer hospitalization and increased inflammation were VTE risk factors.
KW - Cystic fibrosis
KW - Pediatric
KW - Risk stratification
KW - Venous thromboembolism
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U2 - 10.1016/j.thromres.2017.08.022
DO - 10.1016/j.thromres.2017.08.022
M3 - Article
C2 - 28934665
AN - SCOPUS:85029534206
SN - 0049-3848
VL - 158
SP - 161
EP - 166
JO - Thrombosis Research
JF - Thrombosis Research
ER -
