Abstract Number: PB1298
Meeting: ISTH 2020 Congress
Background: Although rare, Pulmonary Embolism (PE) is a potentially life-threatening condition with significant morbidity and mortality and likely underdiagnosed due to non-specific symptoms and a low index of suspicion.
Aims: To evaluate clinical characteristics, diagnosis and treatment of PE in pediatric patients followed at our center in Brazil.
Methods: Retrospective data analysis from 2009 to 2019 of a tertiary center to identify patients < 18 years with PE, objectively diagnosed radiologically. Patient demographics and clinical course were recorded.
Results: The incidence of PE was 3.2 per 10,000 hospitalized patients. Of the 23 cases included, 69.6% occurred during the hospitalization and 52.2% were males. The median age was 11 years (2 days – 17 years) (Figure 1). Sixteen patients (69.5%) presented symptoms. The most common was dyspnea (56.2%), chest pain (50.0%) and hypoxemia (43.7%). The median time from symptoms to diagnosis of PE was one day (0-11 days). Risk factors were central venous catheter (39.1%), malignancy (34.8%) and recent surgery (34.8%). Two or more risk factors were present in sixteen (69.5%) patients. PE was diagnosed by computed tomography pulmonary angiogram in twenty-one patients (91.3%). One patient was ineligible for anticoagulation therapy. Twenty-two patients (95.6%) received unfractioned heparin or low molecular weight heparin. Thrombolysis was not performed. Five patients (22.7%) lost to follow-up and twelve of the remaining seventeen (70.6%) received anticoagulation therapy during 3 to 6 months. Two patients presented bleeding complications: one pulmonary hemorrhage (day 9 of treatment) and one fatal intracranial hemorrhage (day 30 of treatment).
Conclusions: At least one risk factor was identified in all patients diagnosed with PE, which emphasizes the importance of increasing awareness of high-risk pediatric patients. The presence of comorbidities such as malignancy and recent surgery associated with central venous catheter should raise the clinical suspicion for PE even without the classic symptomatology.
[Age of patients at PE diagnosis]
To cite this abstract in AMA style:
Lira L, Celeste D, Garanito M, Carneiro J. Pulmonary Embolism in Pediatric Patients: A Ten-year Experience from a Tertiary Center in Brazil [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/pulmonary-embolism-in-pediatric-patients-a-ten-year-experience-from-a-tertiary-center-in-brazil/. Accessed March 21, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/pulmonary-embolism-in-pediatric-patients-a-ten-year-experience-from-a-tertiary-center-in-brazil/