Incidence of Venous Thromboembolism in Pediatric Orthopedics: A Systematic Review.

Deep veinous thrombosis Musculoskeletal infections Orthopedics pediatrics Pulmonary embolisms Veinous thromboembolism

Journal

Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830

Informations de publication

Date de publication:
07 Feb 2024
Historique:
received: 17 11 2023
revised: 23 01 2024
accepted: 01 02 2024
medline: 10 2 2024
pubmed: 10 2 2024
entrez: 9 2 2024
Statut: aheadofprint

Résumé

Children undergoing orthopedic procedures often present numerous risk factors for thromboembolism. A recent survey, conducted by the pediatric orthopaedic society of north America (POSNA), indicates that pediatric orthopedic surgeons are unaware of venous thromboembolism (VTE) prevention protocols and feel that certain procedures should require thromboprophylaxis. The aim of this systematic review was to properly assess the incidence of VTE in pediatric orthopedics. By using a thorough and broad search of the literature, the incidence according to different subspecialties of pediatric orthopedics was evaluated. A systematic review on VTE in pediatric orthopedics was conducted. Four databases were searched for articles reporting these events. Three major search concepts: "pediatrics", "orthopedic surgery/trauma" and "VTE complications" were used and broken down in MeSH, EmTree and their free vocabulary synonyms for proper literature review. Two independent authors screened 8467 titles and abstracts. Seventy articles reporting VTE in children treated by orthopedic surgeons were selected for data extraction. We reported median incidences by orthopedic subtypes and by study characteristics with a semi-quantitative review model. The 70 articles yielded a total of 845010 participants. Spine articles (33/70) provided 25,2% of the children included in the review. Trauma studies (16/70) accounted for 47.5% of the participants. The overall VTE median incidence was 0.16% [95%CI 0.0 - 1.01%]. Musculoskeletal infections had a noticeably higher median incidence of 3.5% [CI 0.0 - 13.8%]. Small variations were seen for the other subtypes: trauma, spine and elective surgeries. Subgroups by article characteristics did not differ significantly either. Thrombotic complications are rare events in pediatric orthopedics, but knowledge epidemiologic is important because its potential severity. In this review, VTE median incidence for all orthopedic subtypes was around 0.16% [CI 0.0 - 1.01%]. According to subspecialty assessment, musculoskeletal infections were associated with greater risk of VTE occurrence. III - Systematic review.

Sections du résumé

BACKGROUNDS BACKGROUND
Children undergoing orthopedic procedures often present numerous risk factors for thromboembolism. A recent survey, conducted by the pediatric orthopaedic society of north America (POSNA), indicates that pediatric orthopedic surgeons are unaware of venous thromboembolism (VTE) prevention protocols and feel that certain procedures should require thromboprophylaxis. The aim of this systematic review was to properly assess the incidence of VTE in pediatric orthopedics. By using a thorough and broad search of the literature, the incidence according to different subspecialties of pediatric orthopedics was evaluated.
METHODS METHODS
A systematic review on VTE in pediatric orthopedics was conducted. Four databases were searched for articles reporting these events. Three major search concepts: "pediatrics", "orthopedic surgery/trauma" and "VTE complications" were used and broken down in MeSH, EmTree and their free vocabulary synonyms for proper literature review. Two independent authors screened 8467 titles and abstracts. Seventy articles reporting VTE in children treated by orthopedic surgeons were selected for data extraction. We reported median incidences by orthopedic subtypes and by study characteristics with a semi-quantitative review model.
RESULTS RESULTS
The 70 articles yielded a total of 845010 participants. Spine articles (33/70) provided 25,2% of the children included in the review. Trauma studies (16/70) accounted for 47.5% of the participants. The overall VTE median incidence was 0.16% [95%CI 0.0 - 1.01%]. Musculoskeletal infections had a noticeably higher median incidence of 3.5% [CI 0.0 - 13.8%]. Small variations were seen for the other subtypes: trauma, spine and elective surgeries. Subgroups by article characteristics did not differ significantly either.
CONCLUSION CONCLUSIONS
Thrombotic complications are rare events in pediatric orthopedics, but knowledge epidemiologic is important because its potential severity. In this review, VTE median incidence for all orthopedic subtypes was around 0.16% [CI 0.0 - 1.01%]. According to subspecialty assessment, musculoskeletal infections were associated with greater risk of VTE occurrence.
LEVEL OF EVIDENCE METHODS
III - Systematic review.

Identifiants

pubmed: 38336248
pii: S1877-0568(24)00032-X
doi: 10.1016/j.otsr.2024.103830
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

103830

Informations de copyright

Copyright © 2024. Published by Elsevier Masson SAS.

Auteurs

Mathieu Boulet (M)

Department of surgery, Division of orthopaedic surgery, CHU de Québec, Université Laval, Québec (QC), Canada.

Tristan Langlais (T)

Orthopaedic Paediatric Department, Children'hospital, CHU Purpan, Toulouse Universitary, Toulouse, France.

Stéphane Pelet (S)

Department of surgery, Division of orthopaedic surgery, CHU de Québec, Université Laval, Québec (QC), Canada.

Étienne Belzile (É)

Department of surgery, Division of orthopaedic surgery, CHU de Québec, Université Laval, Québec (QC), Canada.

Caroline Forsythe (C)

Department of surgery, Division of orthopaedic surgery, CHU de Québec, Université Laval, Québec (QC), Canada. Electronic address: forsythecaroline@hotmail.com.

Classifications MeSH