Demographic and clinical characteristics of venous thromboembolism in children

Abstract

Objective: To describe the demographic and clinical characteristics of venous thromboembolism in children at two tertiary hospitals in Kenya.

Design: Descriptive retrospective chart review.

Setting: Aga Khan University Hospital and Gertrude’s Children’s Hospital Nairobi.

Participants: Patients aged one month to 18 years diagnosed with radiologically confirmed venous thromboembolism between January  2014 and December 2022. 

Main outcome measures: Continuous data: age.

Discrete data: proportion of patients, the time from onset of symptoms to the radiologic diagnosis of venous thromboembolism and the  length of hospital stay. 

Categorical data: sex distribution, unit of hospital admission, site of venous thromboembolism, diagnostic  imaging modality and complications. Other outcome measures included factors associated with the development of venous  thromboembolism, and its management. 

Results: Sixty patients were included in the present study with 5.6 venous thromboembolic  events/ 10,000 hospital admissions documented. Venous thromboembolism was predominantly observed in adolescents at 41.7% with a female predominance of 61.7%. Most patients (86.7%) developed venous thromboembolism during their hospital stay. The median time  from admission to diagnosis was three days while the median length of hospital stay was 13 days. Underlying infection and malignancy  were the most common comorbidities. Resolution of the thrombosis was documented in most patients (51.6%) and the case-fatality ratio  was 11.7%. 

Conclusion: The number of children with venous thromboembolism in this setting compares with that from high-income  countries from two decades ago. At least a quarter of these patients had associated morbidity and mortality.