Study Finds Venous Thromboembolism Prophylaxis Effective in Pediatric Trauma Patients
The indications, safety, and efficacy of chemical venous thromboembolism prophylaxis (cVTE) in pediatric trauma patients remain unclear. A set of high-risk criteria to guide chemical venous thromboembolism prophylaxis use was recently recommended; however, these criteria have not been evaluated prospectively.
Therefore the present study was conducted to examine high-risk criteria and cVTE use in a prospective multi-institutional study of pediatric trauma patients.
This cohort study was completed in 8 free-standing pediatric hospitals were the participants were pediatric trauma patients younger than 18 years who met defined high-risk criteria on admission.
The results showed that among 460 high-risk pediatric trauma patients, the median age was 14.5 years, out of which 68% were male and 32% were female. A total of 54.5% of patients received cVTE; 13.5% received cVTE within 24 hours of admission. Patients who received cVTE after 24 hours had more high-risk factors. The most common reason for delayed cVTE was central nervous system bleeding. VTE occurred in 1 of 62 patients receiving cVTE within 24 hours, 13 of 189 patients receiving cVTE after 24 hours, and 11 of 209 who had no cVTE.
Based on the results, the authors concluded that in this prospective study, the use of cVTE based on a set of high-risk criteria was safe and did not lead to bleeding complications. Delay in initiation of cVTE was significantly associated with the development of VTE. Quality improvement in pediatric VTE prevention may center on the timing of prophylaxis and barriers to implementation.
Ref: Witte AB, Van Arendonk K, Bergner C, et al. Venous Thromboembolism Prophylaxis in High-Risk Pediatric Trauma Patients. JAMA Surg. Published online July 31, 2024. doi:10.1001/jamasurg.2024.2487
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