Risk of venous thromboembolism in children after general surgery

Background/purpose: The purpose of the study was to determine absolute and relative rates of venous thromboembolism (VTE) following general surgical procedures in children compared to the general population. Methods: We analyzed data from all patients under the age of 18 years in the Clinical Pr...

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Main Authors: Humes, David J., Nordenskjöld, Agneta, Walker, Alex J., West, Joe, Ludvigsson, Jonas F.
Format: Article
Published: Elsevier 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/39135/
http://dx.doi.org/10.1016/j.jpedsurg.2015.05.010
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author Humes, David J.
Nordenskjöld, Agneta
Walker, Alex J.
West, Joe
Ludvigsson, Jonas F.
author_facet Humes, David J.
Nordenskjöld, Agneta
Walker, Alex J.
West, Joe
Ludvigsson, Jonas F.
author_sort Humes, David J.
building Nottingham Research Data Repository
collection Online Access
description Background/purpose: The purpose of the study was to determine absolute and relative rates of venous thromboembolism (VTE) following general surgical procedures in children compared to the general population. Methods: We analyzed data from all patients under the age of 18 years in the Clinical Practice Research Datalink, linked to Hospital Episode Statistics from England (2001–2011) undergoing a general surgical procedure and population controls. Crude rates of VTE and adjusted hazard ratios were calculated using Cox regression. Results We identified 15,637 children who had a surgical procedure with 161,594 controls. Six children undergoing surgery had a VTE diagnosed in the year after compared to five children in the population cohort. The overall rate of VTE following surgery was 0.4 per 1000 person years (pyrs) (95% confidence interval [CI] 0.15–0.88) compared to 0.04 per 1000 pyrs (95% CI 0.02–0.09) in the population cohort. This represented a 9 fold increase in risk compared to the population cohort (adjusted hazard ratio [HR] 8.80; 95% CI 2.59–29.94). Conclusions Children are at increased risk for VTE following general surgical procedures compared to the general population however the absolute risk is small and given this the benefits of thromboprophylaxis need to be balanced against the risk of complications following its use.
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spelling nottingham-391352020-05-04T17:07:44Z https://eprints.nottingham.ac.uk/39135/ Risk of venous thromboembolism in children after general surgery Humes, David J. Nordenskjöld, Agneta Walker, Alex J. West, Joe Ludvigsson, Jonas F. Background/purpose: The purpose of the study was to determine absolute and relative rates of venous thromboembolism (VTE) following general surgical procedures in children compared to the general population. Methods: We analyzed data from all patients under the age of 18 years in the Clinical Practice Research Datalink, linked to Hospital Episode Statistics from England (2001–2011) undergoing a general surgical procedure and population controls. Crude rates of VTE and adjusted hazard ratios were calculated using Cox regression. Results We identified 15,637 children who had a surgical procedure with 161,594 controls. Six children undergoing surgery had a VTE diagnosed in the year after compared to five children in the population cohort. The overall rate of VTE following surgery was 0.4 per 1000 person years (pyrs) (95% confidence interval [CI] 0.15–0.88) compared to 0.04 per 1000 pyrs (95% CI 0.02–0.09) in the population cohort. This represented a 9 fold increase in risk compared to the population cohort (adjusted hazard ratio [HR] 8.80; 95% CI 2.59–29.94). Conclusions Children are at increased risk for VTE following general surgical procedures compared to the general population however the absolute risk is small and given this the benefits of thromboprophylaxis need to be balanced against the risk of complications following its use. Elsevier 2015-05-31 Article PeerReviewed Humes, David J., Nordenskjöld, Agneta, Walker, Alex J., West, Joe and Ludvigsson, Jonas F. (2015) Risk of venous thromboembolism in children after general surgery. Journal of Pediatric Surgery, 50 (11). pp. 1870-1873. ISSN 1531-5037 Deep vein thrombosis Pulmonary embolus General surgery http://www.sciencedirect.com/science/article/pii/S0022346815003644 http://dx.doi.org/10.1016/j.jpedsurg.2015.05.010 http://dx.doi.org/10.1016/j.jpedsurg.2015.05.010
spellingShingle Deep vein thrombosis Pulmonary embolus General surgery
Humes, David J.
Nordenskjöld, Agneta
Walker, Alex J.
West, Joe
Ludvigsson, Jonas F.
Risk of venous thromboembolism in children after general surgery
title Risk of venous thromboembolism in children after general surgery
title_full Risk of venous thromboembolism in children after general surgery
title_fullStr Risk of venous thromboembolism in children after general surgery
title_full_unstemmed Risk of venous thromboembolism in children after general surgery
title_short Risk of venous thromboembolism in children after general surgery
title_sort risk of venous thromboembolism in children after general surgery
topic Deep vein thrombosis Pulmonary embolus General surgery
url https://eprints.nottingham.ac.uk/39135/
https://eprints.nottingham.ac.uk/39135/
https://eprints.nottingham.ac.uk/39135/
http://dx.doi.org/10.1016/j.jpedsurg.2015.05.010