Vavilala et al identified risk factors for venous thromboembolism in pediatric trauma patients. These can help identify patients who may benefit from closer monitoring and prophylactic therapy. The authors are from the University of Washington and the Johns Hopkins University.


Risk factors for thromboembolism:

(1) Injury Severity Scores (ISS) >= 9, with further increase if >= 25

(2) major vascular injury

(3) craniotomy

(4) central venous catheters

(5) age >= 5, with further increase if >= 10 years of age


Procedures associated with increased risk:

(1) open reduction and internal fixation of lower extremity fractures

(2) laparotomy

(3) spinal procedure

These proceedures (plus craniotomy) are performed for major injuries to head, spine, thorax, abdomen or extremities, reflecting a high ISS.


The relative risk was high (> 15) for:

(1) ISS >= 25

(2) major vascular injury


The relative risk was moderate (5-7) for:

(1) ISS >= 9

(2) central venous catheter

(3) craniotomy

(4) age >= 10


The relative risk was low (2) for:

(1) age 5 - 9


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