دورية أكاديمية
Differentiation of Deep Venous Thrombosis Among Children With or Without Osteomyelitis.
| العنوان: | Differentiation of Deep Venous Thrombosis Among Children With or Without Osteomyelitis. |
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| المؤلفون: | Ligon JA; Department of Hematology/Oncology, Johns Hopkins Hospital, Baltimore, MD., Journeycake JM; Departments of Hematology/Oncology., Josephs SC; Radiology., Tareen NG; Orthopaedic Surgery, Children's Health System of Texas., Lindsay EA; Orthopaedic Surgery, Children's Health System of Texas., Copley LAB; Departments of Orthopaedic Surgery and Pediatrics, University of Texas Southwestern, Dallas, TX. |
| المصدر: | Journal of pediatric orthopedics [J Pediatr Orthop] 2018 Nov/Dec; Vol. 38 (10), pp. e597-e603. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins Original Publication: New York Ny : Raven Press |
| مواضيع طبية MeSH: | Osteomyelitis/*epidemiology , Venous Thrombosis/*epidemiology, Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Comorbidity ; Female ; Humans ; Infant ; Male ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/prevention & control ; Retrospective Studies |
| مستخلص: | Background: Children with osteomyelitis are at risk for deep venous thrombosis (DVT). This study evaluates the characteristics of DVT among children to differentiate between those with and without osteomyelitis. Methods: Children with DVT of any cause were studied between 2008 and 2016. Children with DVT and osteomyelitis were compared with those with DVT without osteomyelitis. Another comparison cohort included children with osteomyelitis but without DVT. Comorbidities, severity of illness (SOI), and clinical course were compared between cohorts. Results: DVT was identified in 224 children, a prevalence of 2.5 per 10,000 children. Among those with DVT, 28 (12.1%) had osteomyelitis. The DVT rate among 466 children with osteomyelitis was 6.0%. Children with osteomyelitis and DVT had greater SOI (9.1 vs. 2.7), bacteremia rate (82.1% vs. 38.4%), methicillin-resistant Staphylococcus aureus rate (89.3% vs. 21.2%), surgeries per child (2.1 vs. 0.7), and intensive care unit admission rate (67.9% vs. 5.9%) than that of children without DVT (P<0.00001). Of 196 children who had DVT without osteomyelitis, 166 (84.7%) had comorbidities including defined hypercoagulability (27 or 13.8%). Children with DVT due to osteomyelitis were without comorbidities or hypercoagulability (P<0.00001). The rate of pulmonary embolism was similar for children with DVT with or without osteomyelitis (3/28, or 10.7% vs. 18/196, or 9.2%). Conclusions: Children with DVT and osteomyelitis differ substantially from other children with DVT by the absence of comorbidities or post-thrombotic syndrome. They also differ from children with osteomyelitis without DVT by higher SOI, methicillin-resistant S. aureus rate, and occurrence of intensive care. Awareness of for the characteristics of DVT among children with osteomyelitis will reduce delay to diagnostic ultrasound and improve anticoagulation management which must be carefully coordinated given the high rate of surgery of these children. Level of Evidence: Level II-prognostic, retrospective cohort comparison. |
| تواريخ الأحداث: | Date Created: 20180807 Date Completed: 20181211 Latest Revision: 20181211 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1097/BPO.0000000000001240 |
| PMID: | 30080773 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1539-2570 |
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| DOI: | 10.1097/BPO.0000000000001240 |