医学
指南
一致性
置信区间
入射(几何)
随机对照试验
急诊医学
回顾性队列研究
儿科
重症监护医学
内科学
物理
病理
光学
作者
Arash Mahajerin,John K. Petty,Sheila J. Hanson,Veronika Shabanova,E. Vincent S. Faustino
出处
期刊:Journal of Pediatric Hematology Oncology
[Ovid Technologies (Wolters Kluwer)]
日期:2021-04-21
卷期号:44 (2): e349-e357
被引量:5
标识
DOI:10.1097/mph.0000000000002167
摘要
Despite a practice management guideline and risk prediction model for venous thromboembolism (VTE), pediatric-specific evidence on pharmacologic prophylaxis is lacking. In a retrospective study, we characterized receipt of prophylaxis and explored its effectiveness in hospitalized injured patients below 18 years old using data from the Trauma Quality Improvement Program. Concordance of receipt of prophylaxis with guideline and predicted risk of VTE was estimated using κ statistic. Effectiveness was explored using cohorts matched based on the risk prediction model. A total of 11,165 (6.2%) of 180,932 patients received prophylaxis. Those who received prophylaxis were more commonly post-pubertal and more severely injured. Receipt of prophylaxis was fairly concordant with the guideline (κ=0.32) and predicted risk of VTE (κ=0.29). Receipt of prophylaxis was associated with higher rates of VTE likely due to confounding by indication. Low molecular weight heparin seemed more effective against VTE than unfractionated heparin (incidence rate ratio: 0.52; 95% confidence interval: 0.36, 0.75), but less effective when received ≥72 hours after admission to the hospital. We showed that hospitalized injured children did not commonly receive prophylaxis. We also showed that prophylaxis may be effective in hospitalized injured children, but it needs to be proven definitively in a randomized clinical trial.
科研通智能强力驱动
Strongly Powered by AbleSci AI