美国儿童医院婴儿静脉血栓栓塞症的预测因素：一项回顾性儿科健康信息研究。
Predictors of venous thromboembolism among infants in children's hospitals in the United States: a retrospective Pediatric Health Information Study.
机构信息
Division of Neonatology, Department of Pediatrics, LAC + USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
出版信息
J Perinatol. 2022 Jan;42(1):103-109. doi: 10.1038/s41372-021-01232-1. Epub 2021 Oct 16.
OBJECTIVES
Examine: (1) Prevalence of diagnosed venous thromboembolism (VTE) in infants <6 months discharged from U.S. NICUs; (2) Associations between sociodemographic and clinical factors and VTE; (3) Secondary outcomes related to VTE.
STUDY DESIGN
Multivariable logistic regressions examined associations between VTE and sociodemographic and clinical factors among infants <6 months discharged from Pediatric Health Information System (PHIS) NICUs between 2016 and 2019.
RESULTS
Of 201,033 infants, 2720 (1.35%) had diagnosed VTE. Birthweight 300-1000 g (aOR 3.14, 95% CI 2.54-3.88), 1000-1500 g (aOR 1.77, 95% CI 1.40-2.42) versus 2500-3999 g, and public (aOR 1.18, 95% CI 1.02-1.37) versus private insurance were associated with increased odds of VTE, as were CVC, TPN, mechanical ventilation, infection, ECMO, and surgery. All types of central lines (non-tunneled and tunneled CVCs, PICCs, and umbilical catheters) had higher odds of VTE than not having that type of line. CVCs in upper versus lower extremities had higher odds of VTE.
CONCLUSION
Infants with risk factors may require monitoring for VTE. Results may inform VTE prevention.
目的
研究：（1）美国新生儿重症监护病房（NICU）出院的<6 个月婴儿中确诊的静脉血栓栓塞症（VTE）的患病率；（2）社会人口学和临床因素与 VTE 之间的关系；（3）与 VTE 相关的次要结局。
研究设计
多变量逻辑回归分析了 2016 年至 2019 年期间，儿科健康信息系统（PHIS）NICU 出院的<6 个月婴儿中 VTE 与社会人口学和临床因素之间的关系。
结果
在 201033 名婴儿中，有 2720 名（1.35%）被诊断为 VTE。出生体重 300-1000g（aOR 3.14，95%CI 2.54-3.88）、1000-1500g（aOR 1.77，95%CI 1.40-2.42）与 2500-3999g，公共（aOR 1.18，95%CI 1.02-1.37）与私人保险与 VTE 的发生几率增加相关，CVC、TPN、机械通气、感染、ECMO 和手术也是如此。所有类型的中央导管（非隧道和隧道 CVC、PICC 和脐导管）发生 VTE 的几率均高于未使用该类型导管。与下肢相比，上肢的 CVC 发生 VTE 的几率更高。
结论
有危险因素的婴儿可能需要监测 VTE。结果可能为 VTE 的预防提供信息。
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