About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Risk of Life-Threatening Blood Clots in Hospitalized Children Explored by Study

by Rukmani Krishna on December 14, 2013 at 12:56 PM
Font : A-A+

 Risk of Life-Threatening Blood Clots in Hospitalized Children Explored by Study

Life-threatening blood clots occur so rarely in children that the condition, known as venous thromboembolism (VTE), is often not on pediatricians' mental radar screens. This absence can lead to woefully delayed recognition and treatment.
Now findings of a Johns Hopkins Children's Center study, published online Dec. 12 in The Journal of Pediatrics, may help clinicians determine which hospitalized children are at greatest risk of VTE and require vigilant monitoring or preemptive treatment with anticlotting medications.

Advertisement




The investigators say that in the absence of much-needed pediatric guidelines on VTE prophylaxis in children, the study findings can help guide clinical decision-making for certain categories of hospitalized patients who are at a disproportionately high risk for developing clots. Such categories include older teens and young adults, those with multiple medical conditions, patients with central venous catheters and those with cardiac and renal disease.


The study, which analyzed 15 years'' worth of medical records of thousands of children treated at the Johns Hopkins Children''s Center between 1994 and 2009, found 270 cases of VTE in more than 90,000 pediatric admissions. Despite the miniscule overall VTE rate, clotting risk loomed large in several groups, with older age and the presence of multiple medical conditions carrying the highest risk of VTE. Young adults between the ages of 18 and 21 were eight times more likely to develop a clot than younger children between the ages of 2 and 9. Teens, ages 14 to 17, had a four-fold rate of VTEs, compared with younger children. In addition, teenage girls and young women were nearly two times as likely to develop a clot as males the same age. Children with four or more medical conditions were four times more likely to develop VTE than others.


Other factors that appeared to fuel clotting risk were the presence of central venous catheters, recent surgery and traumatic injuries. Half of the 238 children who developed clots had a central venous catheter, and 40 percent of clots developed in children who''d undergone recent surgeries. When clots developed in infants, they did so predominantly in patients with congenital heart defects. By contrast, clots in trauma patients tended to develop mostly in older teens and young adults.
The research team says that children who fall into more than one category should be monitored extra vigilantly for signs suggestive of a clot.


"Are we saying that every kid with more than one risk factor should be on prophylactic treatment? Absolutely not," says study lead investigator Cliff Takemoto, M.D., a pediatric hematologist at the Johns Hopkins Children''s Center. "What we are saying, however, is that we, as clinicians, should take a closer look at each and every patient with multiple risk factors and gauge cumulative risk - if the chance of clotting appears high enough, then treatment is certainly reasonable."


Considered somewhat of a clinical enigma in children, VTEs have been long recognized as a major threat in hospitalized and immobilized adults. This well-established risk is at the heart of guidelines that call for preventive anticlotting therapy in adults with certain conditions. But because clotting risk in children is so poorly understood, the researchers say, pediatricians often find themselves at a loss when trying to decide whom to treat and when. In addition, because anticlotting medications can cause harmful side effects including excess bleeding and low platelet counts physicians are understandably hesitant to use them preemptively in children.


"Blood clots in children are quite rare, yet when they do occur they can be life-threatening, so treatment decisions often pose an intricate dilemma for clinicians who have to weigh the small risk of a potentially fatal condition against the possibility of serious harm that can come from prophylactic treatment," Takemoto says.


Findings of the new study add to a growing body of research on clotting risk in children. Another recent Johns Hopkins study, published Oct. 30 in JAMA Surgery, found that VTE risk among children with traumatic injuries rose dramatically in those 16 and older. Patients in that age group were nearly four times more likely to develop life-threatening blood clots than their younger counterparts.

Advertisement

Usually arising in the veins of the legs, blood clots can break away and travel to the lungs where they lodge in the arteries, obstruct breathing and cause a potentially fatal condition known as pulmonary embolism. Signs of deep vein clots include pain, tenderness and swelling at the site of clot formation, usually in the legs or arms. Symptoms suggestive of pulmonary embolism include chest pain, rapid and labored breathing, spitting blood and fainting.


Source: Newswise
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
Is COVID-19 Vaccination during Pregnancy Safe?
Sensory Processing Disorder (SPD)
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Thalassemia Height and Weight-Kids Thoracic Outlet Syndrome Blood in Stools - Symptom Evaluation Bombay Blood Group Beauty Parlor Stroke Syndrome Common Side Effects of Anticoagulants / Blood Thinners Gastrointestinal bleeding (GI Bleed) Is it Normal to have Blood Clots during Menstruation? 

Recommended Reading
Pulmonary Embolism and Deep Vein Thrombosis
Deep vein thrombosis (DVT) is a condition where blood clots develop usually in the deep veins of ......
Pulmonary Embolism
Pulmonary embolism (PE) is a complication that results from a block in the main artery supplying ......
Risk Factor for Venous Thromboembolism Identified
Patients with superficial vein thrombosis (common vein condition) are more likely to develop venous ...
Beauty Parlor Stroke Syndrome
Beauty parlor stroke syndrome is a form of vertebrobasilar insufficiency that causes symptoms of mil...
Blood in Stools - Symptom Evaluation
Blood in stools results from bleeding that arises from any part of the digestive tract. Causes of bl...
Bombay Blood Group
Bombay blood group is a rare blood type in which the people have an H antigen deficiency. They can r...
Common Side Effects of Anticoagulants / Blood Thinners
The main side effect of anticoagulants or blood thinners is bleeding. Others include reduced platele...
Gastrointestinal Bleeding (GI Bleed)
Gastrointestinal Bleeding refers to hemorrhage that occurs from one or more portions of the digestiv...
Is it Normal to have Blood Clots during Menstruation?
Blood clots during the menstrual cycle is a normal occurrence during heavier menstrual bleeding (men...
Thalassemia
Thalassemia is an inherited blood disorder passed on through parental genes causing the body to prod...
Thoracic Outlet Syndrome
Thoracic outlet syndrome (TOS) is a rare condition that occurs when blood vessels or nerves become c...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use