RT Journal Article
SR Electronic
T1 Venous thromboembolism in children undergoing surgery: incidence, risk factors and related adverse events
JF World Journal of Pediatric Surgery
JO World Jnl Ped Surgery
FD BMJ Publishing Group Ltd
SP e000084
DO 10.1136/wjps-2019-000084
VO 3
IS 1
A1 Mets, Elbert Johann
A1 McLynn, Ryan Patrick
A1 Grauer, Jonathan Newman
YR 2020
UL http://wjps.bmj.com/content/3/1/e000084.abstract
AB Background Although less common in adults, venous thromboembolism (VTE) in children is a highly morbid, preventable adverse event. While VTE has been well studied among pediatric hospitalized and trauma patients, limited work has been done to examine postoperative VTE in children undergoing surgery.Methods Using data from National Surgical Quality Improvement Project Pediatric database (NSQIP-P) from 2012 to 2016, a retrospective cohort analysis was performed to determine the incidence of, and risk factors for, VTE in children undergoing surgery. Additionally, the relationships between VTE and other postoperative adverse outcomes were evaluated.Results Of 361 384 pediatric surgical patients, 378 (0.10%) were identified as experiencing postoperative VTE. After controlling for patient and surgical factors, we found that American Society of Anesthesiologists (ASA) class of II or greater, aged 16–18 years, non-elective surgery, general surgery (compared with several other surgical specialties), cardiothoracic surgery (compared with general surgery) and longer operative time were significantly associated with VTE in pediatric patients (p<0.001 for each comparison). Furthermore, a majority of adverse events were found to be associated with increased risk of subsequent VTE (p<0.001).Conclusion In a large pediatric surgical population, an incidence of postoperative VTE of 0.10% was observed. Defined patient and surgical factors, and perioperative adverse events were found to be associated with such VTE events.