Trends and Risk Factors of Pediatric Venous Thromboembolism in Spain: A Nationwide Study from 2016 to 2023
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Patient Selection
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | p (*) | |
---|---|---|---|---|---|---|---|---|---|---|
Women | 2935 (45.1) | 381 (43.6) | 346 (43.3) | 323 (45.9) | 321 (43.4) | 338 (47.5) | 380 (45.5) | 398 (45.6) | 448 (45.9) | 0.174 |
Age (years) | 3 (0–13) | 1 (0–11) | 3 (0–12) | 3 (0–13) | 2 (0–12) | 3 (0–14) | 4 (0–14) | 4 (0–14) | 7 (0–13) | 0.165 |
Previous VTE | 65 (1.0) | 8 (0.9) | 3 (0.4) | 6 (0.9) | 11 (1.5) | 7 (1) | 6 (0.7) | 9 (1) | 15 (1.5) | 0.112 |
Cancer | 674 (10.4) | 129 (14.8) | 102 (12.8) | 59 (8.4) | 49 (6.6) | 75 (10.5) | 85 (10.2) | 66 (7.6) | 109 (11.2) | 0.002 |
COVID-19 | 95 (1.5) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (0.3) | 26 (3.1) | 47 (5.4) | 20 (2) | <0.001 |
Liver disease | 567 (8.7) | 44 (5) | 32 (4) | 42 (6) | 75 (10.1) | 66 (9.3) | 69 (8.3) | 91 (10.4) | 148 (15.2) | <0.001 |
CKD | 155 (2.4) | 17 (1.9) | 31 (3.9) | 16 (2.3) | 14 (1.9) | 15 (2.1) | 16 (1.9) | 25 (2.9) | 21 (2.2) | 0.542 |
Connective tissue disease | 50 (0.8) | 6 (0.7) | 7 (0.9) | 9 (1.3) | 5 (0.7) | 4 (0.6) | 5 (0.6) | 3 (0.3) | 11 (1.1) | 0.784 |
Sepsis | 344 (5.3) | 41 (4.7) | 54 (6.8) | 37 (5.3) | 40 (5.4) | 40 (5.6) | 28 (3.3) | 51 (5.8) | 53 (5.4) | 0.683 |
CHD | 978 (15.0) | 117 (13.4) | 136 (17) | 126 (17.9) | 111 (15) | 116 (16.3) | 126 (15.1) | 122 (14) | 124 (12.7) | 0.087 |
Sickle cell disease | 41 (0.6) | 6 (0.7) | 2 (0.3) | 5 (0.7) | 4 (0.5) | 5 (0.7) | 5 (0.6) | 6 (0.7) | 8 (0.8) | 0.394 |
Nephrotic syndrome | 44 (0.7) | 5 (0.6) | 10 (1.3) | 5 (0.7) | 5 (0.7) | 8 (1.1) | 1 (0.1) | 4 (0.5) | 6 (0.6) | 0.183 |
Transplantation | 130 (2.0) | 22 (2.5) | 16 (2) | 9 (1.3) | 14 (1.9) | 18 (2.5) | 15 (1.8) | 14 (1.6) | 22 (2.3) | 0.750 |
Thrombophilia | 154 (2.4) | 23 (2.6) | 22 (2.8) | 16 (2.3) | 13 (1.8) | 23 (3.2) | 15 (1.8) | 16 (1.8) | 26 (2.7) | 0.532 |
Overweight or obesity | 112 (1.7) | 12 (1.4) | 12 (1.5) | 9 (1.3) | 10 (1.4) | 21 (2.9) | 12 (1.4) | 13 (1.5) | 23 (2.4) | 0.122 |
Intravascular device | 2083 (32.0) | 362 (41.5) | 300 (37.5) | 230 (32.7) | 222 (30) | 227 (31.9) | 279 (33.4) | 239 (27.4) | 224 (23) | <0.001 |
Contraceptive use | 34 (0.5) | 5 (0.6) | 5 (0.6) | 7 (1) | 2 (0.3) | 4 (0.6) | 1 (0.1) | 4 (0.5) | 6 (0.6) | 0.435 |
CCC | 4625 (71.0) | 662 (75.8) | 597 (74.7) | 497 (70.7) | 537 (72.7) | 512 (71.9) | 579 (69.3) | 574 (65.8) | 667 (68.3) | <0.001 |
Surgery | 71 (1.1) | 2 (0.2) | 4 (0.5) | 3 (0.4) | 8 (1.1) | 13 (1.8) | 9 (1.1) | 19 (2.2) | 13 (1.3) | <0.001 |
Length of stay (days) | 10 (5–23) | 8 (4–22) | 10 (5–24) | 10 (5–22) | 11 (5–23) | 10 (5–26) | 9 (5–22) | 10 (5–26) | 9 (4–21) | 0.909 |
<1 Year | 1–4 Years | 5–9 Years | 10–14 Years | 15–18 Years | p (*) | |
---|---|---|---|---|---|---|
Women | 1105 (43.6) | 411 (42.6) | 343 (45.6) | 420 (42.8) | 656 (51.3) | <0.001 |
Previous VTE | 7 (0.3) | 21 (2.2) | 6 (0.8) | 7 (0.7) | 24 (1.9) | <0.001 |
Cancer | 28 (1.1) | 187 (19.4) | 122 (16.2) | 189 (19.2) | 148 (11.6) | <0.001 |
COVID-19 | 21 (0.8) | 15 (1.6) | 15 (2) | 9 (0.9) | 35 (2.7) | <0.001 |
Liver disease | 37 (1.5) | 144 (14.9) | 114 (15.1) | 166 (16.9) | 106 (8.3) | <0.001 |
CKD | 14 (0.6) | 42 (4.4) | 33 (4.4) | 25 (2.5) | 41 (3.2) | <0.001 |
Connective tissue disease | 5 (0.2) | 6 (0.6) | 8 (1.1) | 13 (1.3) | 18 (1.4) | <0.001 |
Sepsis | 144 (5.7) | 50 (5.2) | 30 (4) | 51 (5.2) | 69 (5.4) | 0.538 |
CHD | 744 (29.4) | 85 (8.8) | 67 (8.9) | 41 (4.2) | 41 (3.2) | <0.001 |
Sickle cell disease | 0 (0) | 4 (0.4) | 14 (1.9) | 8 (0.8) | 15 (1.2) | <0.001 |
Thrombophilia | 20 (0.8) | 19 (2) | 23 (3.1) | 34 (3.5) | 58 (4.5) | <0.001 |
Nephrotic syndrome | 6 (0.2) | 21 (2.2) | 6 (0.8) | 3 (0.3) | 8 (0.6) | 0.788 |
Transplantation | 1 (0) | 34 (3.5) | 24 (3.2) | 26 (2.6) | 45 (3.5) | <0.001 |
Surgery | 43 (1.7) | 4 (0.4) | 5 (0.7) | 10 (1) | 9 (0.7) | 0.007 |
Overweight or obesity | 1 (0) | 1 (0.1) | 5 (0.7) | 36 (3.7) | 69 (5.4) | <0.001 |
Intravascular device | 1431 (56.5) | 194 (20.1) | 121 (16.1) | 145 (14.8) | 192 (15) | <0.001 |
Contraceptive use | 0 (0) | 0 (0) | 0 (0) | 2 (0.2) | 32 (2.5) | <0.001 |
CCC | 2089 (82.5) | 673 (69.8) | 496 (65.9) | 650 (66.2) | 717 (56.1) | <0.001 |
Overall | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | |
---|---|---|---|---|---|---|---|---|---|
Lower limb DVT | 3460 | 501 | 421 | 405 | 444 | 390 | 433 | 423 | 443 |
PE | 784 | 62 | 81 | 75 | 89 | 99 | 112 | 136 | 130 |
Upper limb DVT | 189 | 45 | 36 | 10 | 8 | 14 | 25 | 24 | 27 |
Superficial | 104 | 14 | 20 | 6 | 5 | 14 | 11 | 16 | 18 |
Renal | 187 | 34 | 35 | 29 | 14 | 12 | 20 | 17 | 26 |
Portal | 1014 | 107 | 97 | 86 | 104 | 113 | 129 | 169 | 209 |
Other | 772 | 110 | 109 | 92 | 75 | 70 | 106 | 87 | 123 |
Year | Population | Cases | Crude Rate (CI 95%) | <1 Year | 1–4 Years | 5–9 Years | 10–14 Years | 15–18 Years | Age-Standardized Rate (CI 95%) |
---|---|---|---|---|---|---|---|---|---|
2016 | 8,736,116 | 873 | 9.99 (9.34 a 10.68) | 102.46 | 7.26 | 3.38 | 4.37 | 8 | 9.51 (8.88–10.14) |
2017 | 8,736,111 | 799 | 9.15 (8.52 a 9.8) | 84.3 | 7.06 | 4.86 | 3.62 | 7.81 | 8.86 (8.24–9.47) |
2018 | 8,736,859 | 703 | 8.05 (7.46 a 8.66) | 78.13 | 5.56 | 3.62 | 3.3 | 8.06 | 7.96 (7.37–8.55) |
2019 | 8,733,132 | 739 | 8.46 (7.86 a 9.09) | 90.58 | 6.27 | 2.53 | 4.32 | 7.49 | 8.48 (7.87–9.09) |
2020 | 8,699,072 | 712 | 8.18 (7.59 a 8.81) | 80.34 | 6.05 | 3.09 | 4.2 | 8.1 | 8.27 (7.66–8.87) |
2021 | 8,593,001 | 836 | 9.73 (9.08 a 10.41) | 100.47 | 7.89 | 3.11 | 5.13 | 9.53 | 10.02 (9.34–10.7) |
2022 | 8,584,406 | 872 | 10.16 (9.49 a 10.86) | 88.23 | 9.58 | 4.84 | 5.5 | 9.27 | 10.34 (9.66–11.03) |
2023 | 8,562,979 | 976 | 11.4 (10.69 a 12.14) | 77.48 | 11.04 | 7.15 | 9.14 | 8.59 | 11.68 (10.94–12.41) |
Year | Population | Cases | Crude Rate (CI 95%) | <1 Year | 1–4 Years | 5–9 Years | 10–14 Years | 15–18 Years | Age-Standardized Rate (CI 95%) |
---|---|---|---|---|---|---|---|---|---|
2016 | 4,498,422 | 492 | 10.94 (9.99 a 11.95) | 113.07 | 8.09 | 3.79 | 4.62 | 8.48 | 10.39 (9.47–11.32) |
2017 | 4,497,516 | 453 | 10.07 (9.17 a 11.04) | 87.15 | 9.18 | 5.59 | 4.21 | 7.91 | 9.76 (8.86–10.66) |
2018 | 4,497,683 | 380 | 8.45 (7.62 a 9.34) | 84.18 | 6.78 | 3.75 | 3.4 | 7.31 | 8.33 (7.5–9.17) |
2019 | 4,496,846 | 418 | 9.3 (8.43 a 10.23) | 97.15 | 8.32 | 3 | 4.66 | 7.32 | 9.32 (8.42–10.21) |
2020 | 4,478,756 | 374 | 8.35 (7.53 a 9.24) | 87.68 | 5.82 | 3.04 | 4 | 8.07 | 8.45 (7.59–9.31) |
2021 | 4,424,081 | 456 | 10.31 (9.38 a 11.3) | 121.2 | 8.25 | 2.67 | 5.71 | 8.11 | 10.69 (9.71–11.67) |
2022 | 4,419,345 | 474 | 10.73 (9.78 a 11.74) | 101.96 | 10.44 | 5.75 | 5.37 | 7.89 | 10.98 (9.99–11.97) |
2023 | 4,409,571 | 528 | 11.97 (10.97 a 13.04) | 78.22 | 10.41 | 6.77 | 12.01 | 8.28 | 12.24 (11.19–13.28) |
Year | Population | Cases | Crude Rate (CI 95%) | <1 Year | 1–4 Years | 5–9 Years | 10–14 Years | 15–18 Years | Age-Standardized Rate (CI 95%) |
---|---|---|---|---|---|---|---|---|---|
2016 | 4,237,694 | 381 | 8.99 (8.11 a 9.94) | 91.21 | 6.36 | 2.94 | 4.1 | 7.49 | 8.57 (7.71–9.44) |
2017 | 4,238,595 | 346 | 8.16 (7.33 a 9.07) | 81.28 | 4.81 | 4.08 | 2.99 | 7.7 | 7.91 (7.07–8.74) |
2018 | 4,239,176 | 323 | 7.62 (6.81 a 8.5) | 71.72 | 4.27 | 3.47 | 3.18 | 8.87 | 7.56 (6.73–8.38) |
2019 | 4,236,286 | 321 | 7.58 (6.77 a 8.45) | 83.64 | 4.1 | 2.04 | 3.95 | 7.67 | 7.59 (6.76–8.42) |
2020 | 4,220,316 | 338 | 8.01 (7.18 a 8.91) | 72.59 | 6.29 | 3.14 | 4.41 | 8.14 | 8.07 (7.21–8.93) |
2021 | 4,168,920 | 380 | 9.12 (8.22 a 10.08) | 78.55 | 7.51 | 3.57 | 4.51 | 11.03 | 9.32 (8.38–10.26) |
2022 | 4,165,061 | 398 | 9.56 (8.64 a 10.54) | 73.61 | 8.66 | 3.88 | 5.63 | 10.74 | 9.67 (8.72–10.62) |
2023 | 4,153,408 | 448 | 10.79 (9.81 a 11.83) | 76.71 | 11.71 | 7.55 | 6.09 | 8.93 | 11.08 (10.05–12.11) |
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Rueda-Camino, J.A.; Sabrido-Bermúdez, G.; Barba-Martín, R. Trends and Risk Factors of Pediatric Venous Thromboembolism in Spain: A Nationwide Study from 2016 to 2023. J. Clin. Med. 2025, 14, 3950. https://doi.org/10.3390/jcm14113950
Rueda-Camino JA, Sabrido-Bermúdez G, Barba-Martín R. Trends and Risk Factors of Pediatric Venous Thromboembolism in Spain: A Nationwide Study from 2016 to 2023. Journal of Clinical Medicine. 2025; 14(11):3950. https://doi.org/10.3390/jcm14113950
Chicago/Turabian StyleRueda-Camino, José Antonio, Gema Sabrido-Bermúdez, and Raquel Barba-Martín. 2025. "Trends and Risk Factors of Pediatric Venous Thromboembolism in Spain: A Nationwide Study from 2016 to 2023" Journal of Clinical Medicine 14, no. 11: 3950. https://doi.org/10.3390/jcm14113950
APA StyleRueda-Camino, J. A., Sabrido-Bermúdez, G., & Barba-Martín, R. (2025). Trends and Risk Factors of Pediatric Venous Thromboembolism in Spain: A Nationwide Study from 2016 to 2023. Journal of Clinical Medicine, 14(11), 3950. https://doi.org/10.3390/jcm14113950