Predictors of Deep Vein Thrombosis in Pediatric Trauma Based on Demographic, Injury, and Clinical Characteristics.

BACKGROUND/RATIONALE Deep vein thrombosis (DVT) is the second leading cause of morbidity among hospitalized pediatric patients. The current literature evaluates individual risk factors in isolation while failing to comprehensively evaluate other injuries and clinical characteristics.

OBJECTIVES Our study aims to identify various demographic, injury, and clinical characteristics associated with DVT in pediatric polytrauma patients.

METHODS This retrospective cohort study utilized the American College of Surgeons Trauma Quality Improvement Program Participant Use File (ACS-TQIP-PUF) database 2017-2023 to evaluate DVT risk in pediatric patients (<18 years) with polytrauma injuries. Data were further stratified by demographic, injury, and clinical characteristics.

RESULTS A total of 620 pediatric polytrauma patients diagnosed with DVT were included. Risk factors associated with increased DVT incidence included age 15-17 (aOR: 3.03, p < .001), male sex (aOR: 1.40, p = .043), and obese patients (adjusted odds ratio [aOR: 1.48, p = .004]). Patients with penetrating injuries (aOR: 2.10, p < .001), Injury Severity Score >15 (aOR: 3.71, p < .001), severe abdominal trauma (aOR: 1.17, p = .049), undergoing craniotomy (aOR: 2.26, p = .044) or exploratory laparotomy (aOR: 3.17, p < .001), on mechanical ventilation > 72 hr (aOR: 6.53, p < .001), and receiving blood transfusions (aOR: 3.51, p < .001) also had an increased DVT risk.

CONCLUSION Pediatric polytrauma patients aged 15-17, obese, with penetrating severe injuries, on mechanical ventilation >72 hr, undergoing craniotomy or exploratory laparotomy, and those receiving blood transfusions, especially transfusions within 4 hr and massive blood transfusions, are at increased risk of developing DVT.