VENOUS THROMBOEMBOLISM AND ITS OUTCOME IN PEDIATRIC PATIENTS AT A TER-TIARY CARE HOSPITAL OF KARACHI

Abstract

Venous thromboembolism (VTE) was once considered a rare finding in pediatric population but it has been increasing with recent advances in medical care and technology to diagnose it. This study was conducted to determine the clinical presentation, associated factors and outcome of VTE in hospitalized children in a tertiary care children hospital of Karachi. This descriptive cross sectional study was conducted at National Institute of Child Health, Karachi from December 2020 to January 2022. All patients hospitalized with VTE or who were diagnosed to have DVT while at hospital were included in study. Demographic characteristics, clinical presentation, medical history and laboratory workup was recorded in a semi-structured proforma. Patients were managed by treating physicians as per hospital protocol. Treatment details were recorded along with outcome. A Total of 36 children were diagnosed with VTE. Nine (25%) patients were admitted with clinical features suggestive of DVT while remaining 27 (75%) developed DVT during hospital stay. Median hospital stay of those who developed DVT at hospital was 15 days (IQR 10-30days). Infectious etiology (n=21, 58.3%) was the most common admitting diagnosis followed by central nervous system disorders (n=4, 11.1%). Common clinical features among VTE children were fever, seizures and edema of limbs. Prolonged hospital stay with immobilization and central venous catheterization particularly due to infectious etiology are common factors among children who develop VTE and such patients need to be considered for VTE prophylaxis and treatment.

Keywords

• venous thromboembolism
• cerebral sinus thrombosis
• anticoagulation