TY - JOUR
T1 - Current practices in pediatric hospital-acquired thromboembolism
T2 - Survey of the Children's Hospital Acquired Thrombosis (CHAT) Consortium
AU - for the CHAT Consortium Investigators
AU - the VTE Risk Factors and Thromboprophylaxis Working Group of the Pediatric and Neonatal Thrombosis and Hemostasis Subcommittee of the ISTH SSC
AU - Abrams, Christina M.
AU - Jaffray, Julie
AU - Stillings, Amy
AU - Branchford, Brian R
AU - Young, Guy
AU - Goldenberg, Neil A.
AU - Abajas, Yasmina L.
AU - Fargo, John
AU - Crary, Shelly
AU - Kumar, Riten
AU - Woods, Gary
AU - Narang, Shalu
AU - Cooper, James
AU - Silvey, Mike
AU - Garland, Kate
AU - Mahajerin, Arash
AU - Luchtman-Jones, Lori
AU - Torres, Marcela
AU - Wright, Jordan
AU - Pahl, Kristy
AU - Armstrong, Katherine
AU - Braunreiter, Chi
AU - Bakeer, Nihal
AU - Sochet, Anthony
AU - Hogan, Marie
AU - Gupta, Shveta
AU - Knoll, Christine
AU - Hege, Kerry
AU - Schaefer, Beverly
AU - Panigrahi, Arun
AU - Thornburg, Courtney
AU - Shimano, Kristin
AU - Ahuja, Sanjay
AU - Weyand, Angela
AU - Boucher, Alexander
AU - Abajas, Yasmina
AU - Subbaswamy, Anjali
AU - Khan, Osman
AU - Druzgal, Colleen
AU - Maida, Deanna
AU - Wheeler, Allison
AU - Malec, Lynn
AU - Branchford, Brian
AU - Kucine, Nicole Elena
AU - Prozora, Stephanie
N1 - Funding Information:
CMA received grant funding to support her fellowship training on the Research Training in Hematology grant from the National Institutes of Health National Heart, Lung, and Blood Institute (grant number 5T32HL007149). JJ received grant funding for this study from the National Institutes of Health from the National Center for Advancing Translational Science (grant number UL1TR001855), the Children's Hospital Saban Research Mentored Career Development Award and the Hemostasis and Thrombosis Research Society Mentored Research Award, supported by an independent educational grant from Takeda Pharmaceuticals U.S.A. The remaining authors have no relevant financial disclosures.
Publisher Copyright:
© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).
PY - 2022/10
Y1 - 2022/10
N2 - Background: A rise in hospital-acquired venous thromboembolism (HA-VTE) in children has led to increased awareness regarding VTE prophylaxis and risk assessment. Despite this, no consensus exists regarding these practices in pediatrics. Objective: To describe common practices in VTE prophylaxis, VTE risk assessment models, and anticoagulation dosing strategies in pediatric hospitals that are members of the Children's Hospital Acquired Thrombosis (CHAT) Consortium. Methods: An electronic survey of 44 questions evaluating practices surrounding pediatric HA-VTE risk assessment and prevention was distributed between August 9, 2021, and August 30, 2021, to the primary investigators from the 32 institutions within the CHAT Consortium. Results: The survey response rate was 100% (n = 32). In total, 85% (n = 27) of the institutions assess HA-VTE, but only 63% (n = 20) have formal hospital guidelines. Within the institutions with formal guidelines, 100% (n = 20) include acute systemic inflammation or infection and presence of a central venous catheter (CVC) as risk factors for VTE. Pharmacologic prophylaxis is prescribed at 87% (28) of institutions, with enoxaparin being the most frequent (96%, n = 27). Variability in responses persisted regarding risk factors, risk assessment, thromboprophylaxis, dosing of prophylactic anticoagulation or anticoagulant drug monitoring. A majority of providers were comfortable providing thromboprophylaxis across all age groups. In addition, the global coronavirus disease 2019 increased the providers' use of prophylactic anticoagulation 78% (n = 25). Conclusion: Practices among institutions are variable in regard to use of HA-VTE prophylaxis, risk assessment, or guideline implementation, highlighting the need for further research and a validated risk assessment model through groups like the CHAT Consortium.
AB - Background: A rise in hospital-acquired venous thromboembolism (HA-VTE) in children has led to increased awareness regarding VTE prophylaxis and risk assessment. Despite this, no consensus exists regarding these practices in pediatrics. Objective: To describe common practices in VTE prophylaxis, VTE risk assessment models, and anticoagulation dosing strategies in pediatric hospitals that are members of the Children's Hospital Acquired Thrombosis (CHAT) Consortium. Methods: An electronic survey of 44 questions evaluating practices surrounding pediatric HA-VTE risk assessment and prevention was distributed between August 9, 2021, and August 30, 2021, to the primary investigators from the 32 institutions within the CHAT Consortium. Results: The survey response rate was 100% (n = 32). In total, 85% (n = 27) of the institutions assess HA-VTE, but only 63% (n = 20) have formal hospital guidelines. Within the institutions with formal guidelines, 100% (n = 20) include acute systemic inflammation or infection and presence of a central venous catheter (CVC) as risk factors for VTE. Pharmacologic prophylaxis is prescribed at 87% (28) of institutions, with enoxaparin being the most frequent (96%, n = 27). Variability in responses persisted regarding risk factors, risk assessment, thromboprophylaxis, dosing of prophylactic anticoagulation or anticoagulant drug monitoring. A majority of providers were comfortable providing thromboprophylaxis across all age groups. In addition, the global coronavirus disease 2019 increased the providers' use of prophylactic anticoagulation 78% (n = 25). Conclusion: Practices among institutions are variable in regard to use of HA-VTE prophylaxis, risk assessment, or guideline implementation, highlighting the need for further research and a validated risk assessment model through groups like the CHAT Consortium.
KW - anticoagulants
KW - hospital
KW - pediatric
KW - risk assessment
KW - risk factors
KW - venous thromboembolism
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U2 - 10.1002/rth2.12793
DO - 10.1002/rth2.12793
M3 - Article
AN - SCOPUS:85142112093
SN - 2475-0379
VL - 6
JO - Research and Practice in Thrombosis and Haemostasis
JF - Research and Practice in Thrombosis and Haemostasis
IS - 7
M1 - e12793
ER -