Original article

Blood Transfusion - 4 2018 (July - August)

Paediatric venous thromboembolism: a report from the Italian Registry of Thrombosis in Children (RITI)

Authors

Key words: venous thrombosis, children, registry, Italy
Publication Date: 2017-06-30

Abstract

Background. The Italian Registry of Thrombosis in Children (RITI) was established by a multidisciplinary team with the aims of improving knowledge about neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols.
Materials and methods. We analysed the subset of RITI data concerning paediatric systemic venous thromboembolic events that occurred between January 2007 and June 2013.
Results. Eighty-five deep venous thromboses and seven pulmonary emboli were registered in the RITI. A prevalence peak was observed in children aged 10 to 18 years and, unexpectedly, in children aged 1 to 5 years. A central venous line was the main risk factor (55% of venous thromboembolic events); surgery (not cardiac) (25%), concomitant infections (23%) and malignancy (22%) were the clinical conditions most often associated with the onset of venous thromboembolism. There was a diagnostic delay of more than 24 hours in 37% of the venous thromboembolic events. Doppler ultrasound was the most widely used test for the objective diagnosis of deep venous thrombosis (87%). Antithrombotic therapy was administered in 96% of venous thromboembolic events, mainly low molecular weight heparin (60%). In 2% of cases recurrences occurred, while post-thrombotic syndrome developed in 8.5% of cases.
Discussion. Although the data from the RITI are largely in agreement with published data, peaks of prevalence of thrombosis, risk factors and objective tests used for the diagnosis showed some peculiarities which may deserve attention.

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Authors

Paolo Giordano - Paediatric Haematology and Oncology Unit, University Hospital of Bari, Bari

Massimo Grassi - Paediatric Haematology and Oncology Unit, University Hospital of Bari, Bari

Paola Saracco - Paediatric Haematology, Department of Paediatric Sciences, University Hospital "Città della Salute e della Scienza", Turin

Angelo C. Molinari - Thrombosis and Haemostasis Unit, "Giannina Gaslini" Children's Hospital, Genoa

Chiara Gentilomo - Department of Paediatrics, "Dell'Angelo" Hospital, Venice

Agnese Suppiej - Paediatric Neurology Unit, Paediatric University Hospital of Padua, Padua

Giuseppe Indolfi - Department of Paediatrics, "Anna Meyer" Children's Hospital, Florence

Donatella Lasagni - Department of Paediatrics, "Anna Meyer" Children's Hospital, Florence

Matteo Luciani - Department of Haematology and Oncology and Transfusion Medicine, IRCCS Paediatric Hospital "Bambino Gesù", Rome

Fiammetta Piersigilli - Neonatology Unit, IRCCS Paediatric Hospital "Bambino Gesù", Rome

Maria C. Putti - Department of Oncology and Haematology, University Hospital of Padua, Padua

Lidia L. Rota - Cardiovascular Prevention Centre, Humanitas Research Hospital, Milan

Stefano Sartori - Paediatric Neurology Unit, Paediatric University Hospital of Padua, Padua

Paolo Simioni - Department of Medicine, Thrombotic and Haemorrhagic Diseases Unit, University of Padua Medical School, Padua, Italy

the Paediatric Thrombosis Working Group of the RITI

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