Abstract Number: PB2384
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Prophylaxis
Background: CHEO, a tertiary pediatric hospital in Ottawa, Canada, administers prophylactic anticoagulation to patients with PICCs based on the presence of elevated biochemical and hematological markers of inflammation. There has been no review of the effect of thromboprophylaxis on the burden of catheter associated VTE at our institution.
Aims: The primary objective of this study was to evaluate the effect of thromboprophylaxis on the risk of PICC associated VTE at our institution.
Methods: This is a single-centre retrospective case-control study at a medium-sized pediatric hospital. We included all patients with PICC line associated VTE at CHEO between January 1, 2005 and June 30, 2018, excluding patients with previous thrombosis or known thrombophilia. Information about PICC line insertion, VTE characteristics and inflammatory markers were abstracted from patient charts.
Results: 99 patients had PICC-associated VTE between January 1, 2005 and June 30, 2018. Most VTEs occurred in patients less than 3 months of age(49.5%), followed by adolescents over 12 years of age(22.2%). 52.5% of patients had symptomatic VTE and 58.6% of VTEs were occlusive on imaging. Of 199 patients in our sample 13.6% received thromboprophylaxis with a similar number of recipients in both the VTE case and non-VTE control groups. Thromboprophylaxis was commonly prescribed to adolescents(78%) and rarely given to infants under 3 months of age(3.7%). In our multi-variable regression model we observed no statistically significant association between VTE and thromboprophylaxis, age, female sex, year of placement, ultrasound guidance or raised inflammatory markers. There was an observed association between increasing age and odds of receiving thromboprophylaxis.
Conclusions: This study did not demonstrate a reduction in the probability of PICC-line associated VTE for patients that were prescribed thromboprophylaxis and in our sample, neonates represented the largest population of patients with PICC line associated VTE but were the least likely to receive thromboprophylaxis.
To cite this abstract in AMA style:
Speckert M, Lamontagne S, Tang K, Simpson E. Effectiveness of Thromboprophylaxis in the Prevention of Peripherally Inserted Central Catheter (PICC) Associated Venous Thromboembolism in Pediatric Patients: A Case-control Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/effectiveness-of-thromboprophylaxis-in-the-prevention-of-peripherally-inserted-central-catheter-picc-associated-venous-thromboembolism-in-pediatric-patients-a-case-control-study/. Accessed October 1, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/effectiveness-of-thromboprophylaxis-in-the-prevention-of-peripherally-inserted-central-catheter-picc-associated-venous-thromboembolism-in-pediatric-patients-a-case-control-study/