Outcome of pediatric thromboembolic disease: A report from the Canadian Childhood Thrombophilia Registry

The outcome for children with deep vein thrombosis (DVT) and pulmonary embo lism (PE) is unknown. An understanding of morbidity and mortality of DVT/PE is crucial to the development of rational treatment protocols. The Canadia n Childhood Thrombophilia Registry has followed 405 children aged 1 mo to 1 8 y with DVT/PE for a mean of 2.86 y (range, 2 wk to 6 y) to assess outcome . The all-cause mortality was 65 of 405 children (16%). Mortality directly attributable to DVT/PE occurred in nine children (2.2%), all of whom had ce ntral venous line-associated thrombosis. Morbidity was substantial, with 33 children (8.1%) having recurrent thrombosis, and 50 children (12.4%) havin g postphlebitic syndrome. Recurrent thrombosis and postphlebitic syndrome w ere more common in older children, although deaths occurred equally in all age groups. The incidence of recurrent thrombosis and postphlebitic syndrom e are likely underestimated because of difficulties in diagnosis, especiall y in younger children. The significant mortality and morbidity found in our study supports the need for international multicenter randomized clinical trials to determine optimal prophylactic and therapeutic treatment for chil dren with DVT/PE.