Risk factors for venous thromboembolism in pediatric trauma.

BACKGROUND Venous thromboembolism (VTE) is a major source of morbidity in critically ill trauma patients. Although the incidence and risk factors for VTE after trauma in adults have been well described, similar data regarding pediatric patients are lacking. METHODS Pediatric (age < 16 years) trauma patients with VTE were identified from a large administrative database collated from 19 states across the United States. Risk factors for VTE were identified using multivariate techniques. RESULTS Risk of VTE increased with age and Injury Severity Scores. VTE was clearly associated with head, thoracic, abdominal, lower extremity, and spinal injuries. Craniotomy, laparotomy, and spinal operations were also associated with VTE. The greatest risk of VTE was in children with venous catheters. CONCLUSION Older children with high Injury Severity Scores, major vascular injury, craniotomy, or venous catheters are at risk for VTE. These data may help guide strategies geared toward screening and prophylaxis in injured children.