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Preliminary Results of the Adventh-pediatric Registry in a Southeastern Brazilian City

1State University of Campinas - UNICAMP, Campinas, Brazil, 2Boldrini Hospital, Campinas, Brazil

Abstract Number: PB0805

Meeting: ISTH 2021 Congress

Theme: Pediatrics » Thrombosis in Neonates and Children

Background: There is a lack of epidemiological data regarding pediatric venous thromboembolism (VTE) in Brazil.

Aims: A registry to evaluate the incidence of VTE in hospitalized children (0 to 16 years) in a southeastern Brazilian city.

Methods: A prospective multicenter study initially involving two tertiary hospitals, a pediatric cancer (Boldrini) and a nursery with ICU (Clinical Hospital, UNICAMP), in Campinas, SP-Brazil. All hospitalized patients were evaluated daily, through access to each patient’s electronic medical record and those with a diagnosis of VTE by an objective method were included. All patients with a central venous catheter (CVC) were carefully observed and should undergo doppler ultrasound (US) with any sign of VTE. There was no search for asymptomatic VTE.

Results: During Sept2018 to Feb2021, 971 children were hospitalized and 21 cases of VTE were diagnosed, an incidence of 2.1/100 hospital admissions. Clinical parameters were described in table 1. VTE was located in the upper (n = 8/38.1%) or lower limbs (n = 10/47.6%), portal vein (n=1/4.8%), and pulmonary embolism (n = 1/4,8%). Regarding presentation, 6(28.6%) were incidental, 2(9.5%) malfunctioning CVC and 13(61.9%) with common signs of VTE. VTE was associated with CVC in 10 (47.6%) cases. The mean time between CVC insertion and VTE diagnosis was 22,1 days (± 43.2). The mean time between symptoms/diagnosis was 2,5 (±2.5) days. Risk factors for VTE were found in 95% of the children (table 2). Corticosteroids and asparaginase were the medications more commonly used in VTE patients (33.3% and 4.8% vs. 22.1% and 0.1%, respectively). Therapeutic anticoagulation was used only in 13 (61.9%) patients, because of thrombocytopenia in those with cancer.  

Patients

Non VTE (N=950)

VTE (N=21)

Mean Age  ± SD

6.6  ± 5.3

6.4 ± 5.3

Sex (F/M)

399 / 551

7 / 14

Hospital 

Boldrini 138

HC nursery 603

HC ICU 209

Boldrini 9

HC nursery 6

HC ICU 6

Bed Immobilization

612 (64.4%)

12 (57.1%)

Surgery during Hospitalization

351 (36.9%)

4 (19.0%)

Trauma

32

0

CVC

262 (27.6%)

8 (38.1%)

Hospitalization Time (days)

33.3 ± 704.4

11.8 ± 33.3

ICU 

307 (32.3%)

14 (66.7%)

Demographic and risk factors associated with VTE in children with and without VTE

Patient´s Risk Factors

Cancer

Gastrointestinal 

Congenital Heart Disease

Kidney Disease

Neurological Disease

Others

4 (19.0%)

2 (9.5%)

2 (9.5%)

2 (9.5%)

1 (4.8%)

3 (14.3%)

Thrombosis Risk Factor 

Immobilization 

Infection

Surgery or Intravascular procedure

ICU

CVC

9 (42.8%)

14 (66.7%)

8 (38.1%)

13 (61.9%)

10 (47.6%)

Risk factors associated with VTE

Conclusions: Preliminary data from the first Brazilian VTE pediatric registry indicate it is prevalent among hospitalized children, and largely associated to CVC. 
Supported by a grant of FAPESP, number 2016/14172-6. 
Approved by Ethics Research Committee of Unicamp.

To cite this abstract in AMA style:

Mello T, Rigatto S, Vilela R, Veríssimo M, Rodrigues T, Nunes G, Huber S, Pinheiro V, Pires J, Montalvão S, Annichino-Bizzacchi J. Preliminary Results of the Adventh-pediatric Registry in a Southeastern Brazilian City [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/preliminary-results-of-the-adventh-pediatric-registry-in-a-southeastern-brazilian-city/. Accessed September 29, 2023.

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