Changes in body mass index following venous thromboembolism in children: a prospective cohort study.

BACKGROUND

We hypothesized that acute pediatric venous thromboembolism (VTE) is associated with an increase in body mass index (BMI) over time. We posited that if children gain weight following VTE, targeted interventions may be advised clinically or tested in future studies.

OBJECTIVES

The objectives of our study were to investigate BMI changes from VTE diagnosis to 3 and 6 months after diagnosis, identify predictors, and calculate the prevalence of overweight and obesity.

METHODS

: In this prospective cohort study, we followed 63 participants (mean age, 12.8 years [SD, 5]) for 6 months following first episode of acute VTE. We chose percentage of BMI (%-of-BMI) instead of absolute BMI as a measure of weight to standardize across sex and age and used change in %-of-BMI as a measure of weight change. Δ%-of-BMI was the primary outcome measure documenting change over time, categorized as increased if Δ%-of-BMI was >0, unchanged if Δ%-of-BMI was 0, and decreased if Δ%-of-BMI was <0. To assess BMI changes, we created a prespecified subgroup of participants who required intensive care unit (ICU) vs those who did not.

RESULTS

Sixty-two percent of participants were overweight/obese at diagnosis. Mean %-of-BMI was 102.5% (95% CI, 95-109). The Δ%-of-BMI at 3 and 6 months after diagnosis was, 1.5 (95% CI, -0.8 to 3.6) and 2.2 (95% CI, -0.6 to 5.2), respectively. We identified 3 predictors of weight change: non-ICU stay and longer length of stay predicted weight gain, whereas a higher %-of-BMI at diagnosis in the ICU cohort correlated with decreased BMI.

CONCLUSION

BMI increases following pediatric VTE except those in the ICU. Weight-based counseling and lifestyle changes represent potential targeted interventions after VTE.