@article{7a705c4c92424f02bb2f47419cb54b91,
title = "A multi-institutional registry of pediatric hospital-acquired thrombosis cases: The Children's Hospital-Acquired Thrombosis (CHAT) project",
abstract = "Background Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. Objectives This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model. Methods A registry, which houses pertinent variables from HA-VTE subjects and non-HA-VTE controls, was created for the Children's Hospital-Acquired Thrombosis (CHAT) study. Specific variables from the registry associated with HA-VTE risk will be identified using multivariable regression to create a pediatric HA-VTE risk prediction model to be prospectively validated. Results Seven large pediatric institutions have entered over 600 HA-VTE subjects aged 0–21 years of age into the registry. Subjects showed a male predominance (57%), a median age of three years (IQR 0.3–13) and were most likely admitted to an intensive care unit (57%) at VTE diagnosis. Median time to HA-VTE was 10 days after admission. The most prevalent risk factors include central venous catheters (80%), surgery (43%), systemic steroids (31%), congenital heart disease (27%), infection (14%) and cancer (13%). Conclusions CHAT, with its creation of a risk prediction model with prospective validation using the CHAT registry, is a novel study design and will be the first step in identifying safe and effective strategies to decrease HA-VTE in children by helping define the highest risk population for initial, or more aggressive, thromboprophylaxis efforts.",
keywords = "Hospitals, Pediatric, Pediatrics, Risk assessment, Risk factors, Venous thromboembolism",
author = "Julie Jaffray and Arash Mahajerin and Guy Young and Neil Goldenberg and Lingyun Ji and Richard Sposto and Amy Stillings and Emily Krava and Brian Branchford",
note = "Funding Information: We are grateful for the ongoing contribution from the phase 1 CHAT study sites, which include Stacy Croteau (Boston Children's Hospital), Michael Silvey (Children's Mercy, Kansas City), Nihal Bakeer (Indiana Hemophilia Treatment Center) and Jake Cooper (Children's Hospital of Pittsburgh). We would also like to thank Natalie Smith and Brian Vasquez who made significant contributions in designing the HA-VTE registry used for the CHAT study. This work was supported by a Saban Research Institute Research of Children's Hospital Los Angeles (8030-RRI009907-00) and was accepted into the American Society of Hematology Clinical Research Training Institute (J. Jaffray). This work was also supported by the Hemostasis and Thrombosis Research Society (HTRS) 2016 Mentored Research Award from a grant through Baxalta US Inc. (A. Mahajerin). Funding Information: We are grateful for the ongoing contribution from the phase 1 CHAT study sites, which include Stacy Croteau (Boston Children's Hospital), Michael Silvey (Children's Mercy, Kansas City), Nihal Bakeer (Indiana Hemophilia Treatment Center) and Jake Cooper (Children's Hospital of Pittsburgh). We would also like to thank Natalie Smith and Brian Vasquez who made significant contributions in designing the HA-VTE registry used for the CHAT study. This work was supported by a Saban Research Institute Research of Children's Hospital Los Angeles ( 8030-RRI009907-00 ) and was accepted into the American Society of Hematology Clinical Research Training Institute (J. Jaffray). This work was also supported by the Hemostasis and Thrombosis Research Society (HTRS) 2016 Mentored Research Award from a grant through Baxalta US Inc. (A. Mahajerin). Publisher Copyright: {\textcopyright} 2017 Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2018",
month = jan,
doi = "10.1016/j.thromres.2017.11.019",
language = "English (US)",
volume = "161",
pages = "67--72",
journal = "Thrombosis Research",
issn = "0049-3848",
publisher = "Elsevier Limited",
}