Venous Thromboembolism in Children with Sickle Cell Disease: A Retrospective Cohort Study

J Pediatr. 2018 Jun:197:186-190.e1. doi: 10.1016/j.jpeds.2018.01.073. Epub 2018 Mar 28.


Objectives: To describe the cumulative incidence of venous thromboembolism (VTE) in children with sickle cell disease (SCD) followed at a single institution and report on the risk factors associated with VTE development.

Study design: Charts for all patients with SCD, aged 0-21 years, followed at Nationwide Children's Hospital over a 6-year period (January 1, 2009, to January 31, 2015) were reviewed. Data on VTE diagnosis, sex, body mass index/weight-for-length, SCD genotype, SCD clinical complications, central venous catheter (CVC) placement, and thrombophilia testing were collected.

Results: Cumulative incidence of VTE in children with SCD followed at a single tertiary care institution was found to be 2.9% (12/414). Nine of the 12 VTE were CVC-associated. On univariate analysis, hemoglobin SS genotype (OR 10.7, 95% CI 1.4-83.5), CVC presence (OR 34.4, 95% CI 8.9-134.6), central nervous system vasculopathy (OR 19.4, 95% CI 5.6-63.4), chronic transfusion therapy (OR 30.6, 95% CI 8.9-122.2), and older age (P = .03) were associated with VTE. However, presence of CVC was the only independent risk factor identified on multivariable logistic regression analysis (OR 33.8, 95% CI 8.7-130.9).

Conclusion: In our institution, nearly 3% of children with SCD had a history of VTE. CVC is an independent predictor of VTE in children with SCD.

Keywords: sickle cell disease; venous thromboembolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Sickle Cell / complications*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Genotype
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Risk Factors
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / etiology
  • Young Adult