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Published: 2011

Total Pages: 204

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To date, there is no definitive treatment for PTS in children and therapy is symptomatic. Therefore, the preferred approach to PTS in children is prevention. However, because it has only recently been of interest as a significant adverse DVT outcome in children and adolescents, there is a lack of available information about the risk factors of PTS development in children to prevent its development, especially those that can be modified with behavior or intervention. The purposes of this study are to: (1) identify the relationship between elevated body mass index (BMI) percentile and the incidence and severity of PTS following an episode of deep vein thrombosis, (2) determine if the relationship continues after controlling for genetic and acquired predisposing factors that may also influence the severity of PTS, and 3) identify a profile of children and adolescents at risk for developing PTS. This cross-sectional study was guided by an integration of the Health Promotion Model developed by Pender (1975) and Corbin and Strauss's Chronic Illness Trajectory Model (1987). The integration of these two well-established models provides a framework for considering the needs of acute exacerbations of PTS but also, the intermittent and uncertain chronic symptoms of the disease. Data for this study were extracted from a CDC thrombosis registry with children, from birth through 21 years of age, who were diagnosed with an extremity deep vein thrombosis (DVT). The data were analyzed using descriptive and cross-sectional analysis as well as developing a logistic regression model to find the best predictors for PTS development within this registry. A total of 557 pediatric subjects matched the inclusion criteria. The overall prevalence of PTS for this study was 20%. In this cohort of children, elevated BMI was found to be the best predictor within the logistic regression model that included possible risks for PTS, Elevated BMI in children with an extremity DVT was found to augment the risk of PTS development and severity. Infection, clot persistence and antiphospholipid antibody syndrome were also identified as potential predictors and were associated with higher risk of PTS when they co-occurred with obesity. Other potential predictors of PTS were extended time to diagnosis and treatment as well as the treatment type. Research in PTS suggests that there is merit in identifying predictors of PTS in pediatrics, and provides directions for future prevention efforts.