[PEDIATRIC VENOUS THROMBOEMBOLISM - A COHORT STUDY IN A TERTIARY CENTER].

ABSTRACT

INTRODUCTION: Deep Venous Thrombosis (DVT) is rare among children, yet may yield high morbidity and mortality. Due to the limited data regarding pediatric DVT, its management has been adopted from adults' protocols. Recent research reported associations of DVT and strokes with genetic thrombophilia, especially in the presence of transient risk factors (e.g. hospitalization, malignancy, central venous lines…). AIMS: To evaluate the influence of risk factors within our pediatric DVT cohort of a tertiary center upon treatment and prognosis. METHODS: Retrospective analysis of prospectively collected data at the Sheba Medical Center. RESULTS: During the period 2014-2017, 76 out of 150 cases of acute DVT diagnosed at our center were fully followed. Upper extremity DVT was most commonly observed. Malignancy and a central venous line (CVL) were the most abundant risk factors. Genetic thrombophilia was diagnosed in one third of the cases. The majority of patients were treated with low molecular weight heparin for at least 3 months and 13% continued prolonged anti-coagulation treatment. Neither thrombophilia nor cancer affected the outcome. DISCUSSION: Our results confirm previously published data indicating that malignancy and CVL are the most common risk factors associated with DVT in children, making the upper extremity the most common location of thrombosis. Neither the type of cancer nor genetic thrombophilia was found to be associated with treatment outcome, but they did influence the treatment duration. Risk factors influence the pathogenesis of DVT and influence the duration of treatment.