Ten-Year Single-Center Experience in Pediatric Thromboembolism: Management Strategies and Clinical Outcomes

Background:
The incidence of pediatric thromboembolism (TE), encompassing venous (VTE) and arterial events (ATE), has risen over the past two decades due to heightened awareness and improved diagnostic modalities. This study aimed to evaluate the epidemiology, risk factors, management, and outcomes of pediatric TE over a 10-year period at a tertiary care center.

Methods:
We retrospectively analyzed 51,025 pediatric admissions to Atatürk University Hospital between January 2010 and December 2020. Seventy patients (0.13%) with radiologically confirmed TE were included. Demographic characteristics, risk factors, treatments, and outcomes were systematically reviewed.

Results:
The overall incidence of TE was 13.7 per 10,000 admissions. VTE accounted for 72.9% of cases and ATE for 27.1%. Median age at diagnosis was 6 years (range: 1 day–18 years), and 70% were male. The most frequent site was the central nervous system (40%), followed by extremities (22.9%) and intracardiac thrombosis (18.6%). Central venous catheters (30%) were the leading risk factor, followed by inherited thrombophilia (10.1%), malignancy (7%), and infection (4.2%). Antithrombotic therapy was administered in 87.1% of patients, primarily with low-molecular-weight heparin (81%). Clinical outcomes included complete recovery in 79%, recurrence in 17%, and mortality in 4%.

Conclusion:
Venous thrombosis was the predominant form of TE, with central venous catheters as the principal risk factor. Optimization of catheter placement and maintenance is therefore critical to reducing morbidity. Larger multicenter studies are warranted to refine pediatric-specific guidelines for diagnosis, treatment, and prevention.