Central venous catheters are an important factor in paediatric thrombosis

Aim: To establish the incidence and characteristics of paediatric thrombosis (PT) in a Canadian tertiary care centre during the era of low molecular weight heparin (LMWH). Methods: A retrospective observational case study of all patients <18 years of age evaluated for arterial and venous thrombosis from May 2008 to July 2018 at McMaster Children's Hospital was conducted through the electronic medical record. Results: The incidence of PT was 52.2 per 10000 hospital admissions (n = 477/91462). Provoked thrombosis was more prevalent (88.9%, n = 424/477) than unprovoked (2.9%, n = 14/477) or idiopathic thrombosis (4%, n = 19/477). Half of PT were in children <2 years (51.2%, n = 244/477). Central vascular catheterisation was a contributory factor in more than half of thrombotic events (56.2%, n = 268/477), while trauma (1.1%, n = 5/477), oral contraceptives (4%, n = 19/477), infection (4%, n = 19/477), surgery (6.9%, n = 33/477) and malignancy (8.4%, n = 40/477) were also risk factors. Arterial ischaemic stroke was diagnosed in 11.1% of cases (n = 53/477), while pulmonary embolism was identified in 7.1% (n = 34/477) and 1.7% of cases were fatal (n = 8/477). LMWH was the first-line therapeutic of choice (47.8%, n = 228/477), with 28.1% (n = 134/477) requiring no intervention. Conclusion: These data reiterate the elevated thrombosis risk to which infants and children with central vascular access are exposed.

Automated summary

This study aimed to establish the incidence and characteristics of paediatric thrombosis (PT) in a Canadian tertiary care center during the era of low molecular weight heparin (LMWH). The results showed that central vascular catheterization was a contributory factor in more than half of thrombotic events, highlighting the elevated thrombosis risk to infants and children with central vascular access.