Clinical course of postthrombotic syndrome in children with history of venous thromboembolism

Susan Creary, Mark Heiny, James Croop, Robert Fallon, Terry Vik, Monica Hulbert, Holly Knoderer, Manjusha Kumar, Anjali Sharathkumar

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Postthrombotic syndrome (PTS) is a chronic morbidity of venous thromboembolism (VTE) in children. Information about the evolution of PTS is lacking in children. Present study was aimed to evaluate the time-course of extremity PTS in children who were serially followed in a hematology clinic. This retrospective cohort study included 69 consecutive children with documented VTEs that presented with symptoms of extremity VTE: 67 extremity VTEs with or without extension to vena cava, 2 inferior vena cava VTEs. Severity of PTS was assessed using modified Villalta scale. Median age of the cohort was 12.6 years (interquartile range 1.6-15 years) while median follow-up was 28.7 months (interquartile range 13.3-33.4 months. PTS prevalence was 46.8% [95% confidence interval (CI) 37.9-57.7%]. Lower extremity VTE was associated with development of PTS compared to upper extremity VTE regardless of catheter use (P=0.002). The time-course of PTS fluctuated in 11 of 33 children (33%; 95% CI 20-47%) at a median interval of 12 months from diagnosis of VTE (range 4-14 months): three progressed from mild/moderate to severe, one improved from moderate to mild, seven fluctuated between mild and moderate. Recurrence and incomplete resolution of VTE were associated with variability in PTS severity (P<0.05). In summary, this study suggested that almost 50% of study cohort developed PTS, and the time-course of PTS was not static in one third of children. Future research should focus on identifying the predictors contributing to the worsening of PTS and developing risk-stratified treatment interventions so as to improve the outcome of children with VTE.

Original languageEnglish
Pages (from-to)39-44
Number of pages6
JournalBlood Coagulation and Fibrinolysis
Volume23
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Postthrombotic Syndrome
Venous Thromboembolism
Extremities
Cohort Studies
Confidence Intervals
Venae Cavae
Inferior Vena Cava
Hematology
Upper Extremity
Lower Extremity

Keywords

  • children
  • postthrombotic syndrome
  • venous thromboembolism

ASJC Scopus subject areas

  • Hematology

Cite this

Clinical course of postthrombotic syndrome in children with history of venous thromboembolism. / Creary, Susan; Heiny, Mark; Croop, James; Fallon, Robert; Vik, Terry; Hulbert, Monica; Knoderer, Holly; Kumar, Manjusha; Sharathkumar, Anjali.

In: Blood Coagulation and Fibrinolysis, Vol. 23, No. 1, 01.2012, p. 39-44.

Research output: Contribution to journalArticle

Creary, Susan ; Heiny, Mark ; Croop, James ; Fallon, Robert ; Vik, Terry ; Hulbert, Monica ; Knoderer, Holly ; Kumar, Manjusha ; Sharathkumar, Anjali. / Clinical course of postthrombotic syndrome in children with history of venous thromboembolism. In: Blood Coagulation and Fibrinolysis. 2012 ; Vol. 23, No. 1. pp. 39-44.
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