Evaluation of venous thromboembolism risk factors reveals subtype heterogenicity in children with central venous catheters: a multicenter study from the Children's Hospital Acquired Thrombosis consortium

Julie Jaffray, Maua Mosha, Brian Branchford, Neil A. Goldenberg, Michael Silvey, Stacy E. Croteau, John H. Fargo, James D. Cooper, Nihal Bakeer, Amy Stillings, Emily Krava, Guy Young, Ernest K. Amankwah

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Acutely ill and medically complex children frequently rely on central venous catheters (CVCs) to provide life-sustaining treatment. Unfortunately, catheter-related thrombosis (CRT) is a serious and common complication. Little is known why some with a CVC develop CRT and others develop venous thromboembolism unrelated to the CVC (non-CRT). Objectives: The aim of this study was to identify factors associated with CRT in children with hospital-acquired venous thromboembolism (HA-VTE). Methods: This case-case study included participants in the Children's Hospital Acquired Thrombosis Registry with HA-VTE and CVC aged 0 to 21 years from 8 US children's hospitals. Participants were excluded if they developed HA-VTE prior to CVC insertion or if the CVC insertion date was unknown. Logistic regression models were used to assess associations between clinical factors and CRT status. Results: There were 1144 participants with HA-VTE who had a CVC. CRT developed in 833 participants, and 311 developed non-CRT. Multivariable analysis showed increased odds of CRT (compared with non-CRT) in participants with peripherally inserted central catheters (odds ratio [OR], 3.80; 95% CI, 2.04-7.10; p < .001), CVCs inserted in the femoral vein (OR, 4.45; 95% CI, 1.70-11.65; p = .002), multiple CVCs (OR, 1.42; 95% CI, 1.18-1.71; p < .001), and CVC malfunction (OR, 3.30; 95% CI, 1.80-6.03; p < .001). Conclusion: The findings of this study provide new insights on risk factor differences between CRT and non-CRT. Prevention efforts should be directed at modifying the type of CVC, insertion location, and/or number of CVCs placed, if possible, to decrease the incidence of CRT.

Original languageEnglish (US)
Pages (from-to)2441-2450
Number of pages10
JournalJournal of Thrombosis and Haemostasis
Volume21
Issue number9
DOIs
StatePublished - Sep 2023

Keywords

  • central venous catheter
  • child
  • risk factor
  • thrombosis
  • venous thromboembolism

ASJC Scopus subject areas

  • Hematology

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