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Risk of venous thromboembolism in children after general surgery

Humes, David J.; Nordenskj�ld, Agneta; Walker, Alex J.; West, Joe; Ludvigsson, Jonas F.

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Authors

DAVID HUMES david.humes@nottingham.ac.uk
Clinical Associate Professor

Agneta Nordenskj�ld

Alex J. Walker

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology

Jonas F. Ludvigsson



Abstract

Background/purpose: The purpose of the study was to determine absolute and relative rates of venous thromboembolism (VTE) following general surgical procedures in children compared to the general population.

Methods: We analyzed data from all patients under the age of 18 years in the Clinical Practice Research Datalink, linked to Hospital Episode Statistics from England (2001–2011) undergoing a general surgical procedure and population controls. Crude rates of VTE and adjusted hazard ratios were calculated using Cox regression. Results We identified 15,637 children who had a surgical procedure with 161,594 controls. Six children undergoing surgery had a VTE diagnosed in the year after compared to five children in the population cohort. The overall rate of VTE following surgery was 0.4 per 1000 person years (pyrs) (95% confidence interval [CI] 0.15–0.88) compared to 0.04 per 1000 pyrs (95% CI 0.02–0.09) in the population cohort. This represented a 9 fold increase in risk compared to the population cohort (adjusted hazard ratio [HR] 8.80; 95% CI 2.59–29.94).

Conclusions Children are at increased risk for VTE following general surgical procedures compared to the general population however the absolute risk is small and given this the benefits of thromboprophylaxis need to be balanced against the risk of complications following its use.

Citation

Humes, D. J., Nordenskjöld, A., Walker, A. J., West, J., & Ludvigsson, J. F. (in press). Risk of venous thromboembolism in children after general surgery. Journal of Pediatric Surgery, 50(11), https://doi.org/10.1016/j.jpedsurg.2015.05.010

Journal Article Type Article
Acceptance Date May 25, 2015
Online Publication Date May 31, 2015
Deposit Date Dec 2, 2016
Publicly Available Date Dec 2, 2016
Journal Journal of Pediatric Surgery
Print ISSN 0022-3468
Electronic ISSN 1531-5037
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 50
Issue 11
DOI https://doi.org/10.1016/j.jpedsurg.2015.05.010
Keywords Deep vein thrombosis
Pulmonary embolus
General surgery
Public URL https://nottingham-repository.worktribe.com/output/750938
Publisher URL http://www.sciencedirect.com/science/article/pii/S0022346815003644
Contract Date Dec 2, 2016

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