Venous Thromboembolism in Pediatric Inflammatory Bowel Disease: A Case-Control Study.
J Pediatr Gastroenterol Nutr
; 72(5): 742-747, 2021 05 01.
Article
em En
| MEDLINE
| ID: mdl-33605670
ABSTRACT
OBJECTIVES:
Inflammatory bowel disease (IBD) is associated with increased risk of venous thromboembolism (VTE). Despite this recognized risk, there are limited data and no anticoagulation guidelines for hospitalized pediatric IBD patients. The objectives of this study were to characterize pediatric IBD patients with VTE and determine risk factors.METHODS:
This was a nested case-control study comparing hospitalized children with IBD diagnosed with VTE to those without VTE over a decade at a large referral center. Standard descriptive statistics were used to describe the VTE group. Multivariable conditional logistic regression was used to assess risk factors.RESULTS:
Twenty-three cases were identified. Central venous catheter (CVC) presence (odds ratio [OR] 77.9; 95% confidence interval [CI] 6.9--880.6; Pâ<â0.001) and steroid use (OR 12.7; 95% CI 1.3--126.4; Pâ=â0.012) were independent risk factors. Median age at VTE was 17âyears (interquartile range [IQR] 13.5--18.2), and in 48%, VTE was the indication for admission. Median duration of anticoagulation was 3.8âmonths (IQR 2.3--7.6), and there were no major bleeding events for patients on anticoagulation. There were no patients with known sequelae from VTE, though 22% had severe VTE that required interventions.CONCLUSIONS:
Pediatric patients with IBD are at risk for VTE, although the absolute risk remains relatively low. The safety and efficacy of pharmacologic thromboprophylaxis needs to be further evaluated in this population with attention to risk factors, such as steroid use and presence of CVC.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Doenças Inflamatórias Intestinais
/
Tromboembolia Venosa
Tipo de estudo:
Etiology_studies
/
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Humans
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2021
Tipo de documento:
Article