Journeycake and Buchanan identified risk factors for deep vein thrombosis (DVT) in children with tunneled central venous catheters. These can help identify patients who may benefit from closer monitoring and more aggressive management. The authors are from the University of Texas Southwestern Medical Center and Children's Medical Center in Dallas.


Patient selection: pediatric patient with cancer and a tunneled central venous catheter



(1) thrombotic occlusions of previous catheters

(2) infection of the catheter


Risk factors for deep vein thrombosis:

(1) repeated episodes of thrombotic occlusion

(2) repeated episodes of infection

(3) episodes of both thrombotic occlusion and infection


If no risk factors were present then the odds ratio was low (0.08, involving 2 of 153 patients reported in Table 5).


If both thrombotic and infection occurred then the odds ratio was moderate (6.4, involving 10 of 43 patients).


A patient with risk factors for deep vein thrombosis associated with a catheter may benefit from anticoagulation.


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