Paediatric Haematology and Oncology Unit, University Hospital of Bari, Bari, Italy.
Paediatric Haematology, Department of Paediatric Sciences, University Hospital "Città della Salute e della Scienza", Turin, Italy.
Blood Transfus. 2018 Jul;16(4):363-370. doi: 10.2450/2017.0075-17. Epub 2017 Jun 3.
The Italian Registry of Thrombosis in Children (RITI) was established by a multidisciplinary team with the aims of improving knowledge about neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols.
We analysed the subset of RITI data concerning paediatric systemic venous thromboembolic events that occurred between January 2007 and June 2013.
Eighty-five deep venous thromboses and seven pulmonary emboli were registered in the RITI. A prevalence peak was observed in children aged 10 to 18 years and, unexpectedly, in children aged 1 to 5 years. A central venous line was the main risk factor (55% of venous thromboembolic events); surgery (not cardiac) (25%), concomitant infections (23%) and malignancy (22%) were the clinical conditions most often associated with the onset of venous thromboembolism. There was a diagnostic delay of more than 24 hours in 37% of the venous thromboembolic events. Doppler ultrasound was the most widely used test for the objective diagnosis of deep venous thrombosis (87%). Antithrombotic therapy was administered in 96% of venous thromboembolic events, mainly low molecular weight heparin (60%). In 2% of cases recurrences occurred, while post-thrombotic syndrome developed in 8.5% of cases.
Although the data from the RITI are largely in agreement with published data, peaks of prevalence of thrombosis, risk factors and objective tests used for the diagnosis showed some peculiarities which may deserve attention.
意大利儿童血栓形成登记处（RITI）由一个多学科团队建立，旨在提高对意大利新生儿和儿科血栓形成事件的认识，并为未来制定特定临床试验和诊断-治疗方案提供初步数据来源。
我们分析了 RITI 中关于 2007 年 1 月至 2013 年 6 月期间发生的儿科系统性静脉血栓栓塞事件的数据子集。
RITI 共登记了 85 例深静脉血栓形成和 7 例肺栓塞。在 10 至 18 岁的儿童中观察到发病高峰，出乎意料的是，1 至 5 岁的儿童中也观察到发病高峰。中心静脉置管是主要的危险因素（55%的静脉血栓栓塞事件）；手术（非心脏）（25%）、同时存在感染（23%）和恶性肿瘤（22%）是静脉血栓栓塞症发病最常伴随的临床情况。37%的静脉血栓栓塞事件存在超过 24 小时的诊断延迟。多普勒超声是深静脉血栓形成客观诊断最广泛使用的检查方法（87%）。96%的静脉血栓栓塞事件接受了抗凝治疗，主要是低分子肝素（60%）。2%的病例出现复发，8.5%的病例出现血栓后综合征。
尽管 RITI 的数据与已发表的数据基本一致，但血栓形成的发病高峰、危险因素和用于诊断的客观检查结果显示出一些特点，可能值得关注。
