Background: Thromboembolism (TE) is less prevalent in pediatric population than adult population. However, the incidence of pediatric TE has been increasing over the last decades. Although the risk factors of pediatric TE were published numerously, most reports were studied in Western countries which the settings were quite different from Thai population.  

Aims: To find the current incidence of TE and to determine the risk factors of TE in Thai pediatric population.

Methods: A retrospective case-control study was performed in Faculty of Medicine, Chiang Mai University between 1 January 2008 and 31 December 2018. All patients with TE were diagnosed by imaging studies and categorized as the case group while the age- and gender-matched pediatric inpatients without TE were categorized as the control group. The demographic data and the risk factors of TE were collected.

Results: We enrolled 129 cases and 300 controls. Fifty-six per cent were male and the median age was 1.8 years (min-max, 0-19.5) but both parameters did not differ between both groups. The incidence of TE was 3: 1,000 pediatric admission including 74 with venous TE, 54 with arterial TE and one with combined venous and arterial TE. The incidence of TE was highest in patients aged between 1 month and 1 year. Surgery, heart disease, trauma and center venous catheter insertion were the risk factors of TE in this study (P = 0.006, 0.021, 0.011, < 0.001, respectively). Moreover, patients who had shock, requiring inotropic drugs and receiving steroids also had higher risks of TE development (P = < 0.001, < 0.001 and 0.009, respectively)        

Conclusions: The incidence of TE in inpatient pediatric population is prevalent in this study. Several risk factors associate with TE in pediatric patients. Therefore, TE risk-stratified protocol and TE prophylaxis should be further investigated to prevent inpatient pediatric population who are at risk of TE development.    

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/pediatric-thromboembolism-in-chiang-mai-university-hospital-a-10-year-review/