Postthrombotic Syndrome and Other Outcomes of Lower Extremity Deep Vein Thrombosis in Children

Pediatric lower extremity deep vein thrombosis (LE-DVT) can lead to postthrombotic syndrome (PTS) and other adverse events. We investigated the outcomes of LE-DVT in children. Three groups were compared: non-line-related (Non-LR) DVT, LR DVT in neonates (LR), and LR DVT in non-neonates (LR). A total of 339 children were included (Non-LR, n = 56; LR, n = 95; and LR, n = 188). We found a statistically significant difference in the frequency of PTS ( = .04; 62.5%, 40.0%, and 46.3% in Non-LR, LR, and LR respectively), of recurrent LE-DVT ( = .001; 10.7% and 2.0% in Non-LR and LR respectively), and pulmonary embolism (PE) ( < .001; 19.6% and 3.2% in Non-LR and LR respectively) among groups. There was no difference in DVT resolution ( = .41). Multivariable analysis showed that DVT resolution, triggering event, and sex predicted Modified Villalta Scale (MVS; for pediatric PTS) scores >1; there was an interaction between DVT triggering event and sex. The time to reach an MVS >1 was significantly different when comparing groups (log-rank test, < .001). Moreover, we found a significant difference in baseline MVS scores among groups, but the difference did not appear to change over time. In conclusion, LR LE-DVT had more benign outcomes than Non-LR DVT. Sex, DVT triggering event, and DVT resolution predicted LE-PTS in our cohort.