COSMIN database

Post-thrombotic syndrome in children: a systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors

Authors:
Goldenberg, N. A., Donadini, M. P., Kahn, S. R., Crowther, M., Kenet, G., Nowak-Gottl, U., and Manco-Johnson, M. J.
Abstract:
BACKGROUND: Post-thrombotic syndrome is a manifestation of chronic venous insufficiency following deep venous thrombosis. This systematic review was conducted to critically evaluate pediatric evidence on frequency of occurrence, validity of outcome measures, and prognostic indicators of post-thrombotic syndrome.

DESIGN AND METHODS: A comprehensive literature search of original reports revealed 19 eligible studies, totaling 977 patients with upper/lower extremity deep venous thrombosis. Calculated weighted mean frequency of post-thrombotic syndrome was 26% (95% confidence interval: 23-28%) overall, and differed significantly by prospective/non-prospective analysis and use/non-use of a standardized outcome measure.

RESULTS: Standardized post-thrombotic syndrome outcome measures included an adaptation of the Villalta scale, the Clinical-Etiologic-Anatomic-Pathologic classification, and the Manco-Johnson instrument. Data on validity were reported only for the Manco-Johnson instrument. No publications on post-thrombotic syndrome-related quality of life outcomes were identified. Candidate prognostic factors for post-thrombotic syndrome in prospective studies included use/non-use of thrombolysis and plasma levels of factor VIII activity and D-dimer.

CONCLUSIONS: Given that affected children must endure chronic sequelae for many decades, it is imperative that future collaborative pediatric prospective cohort studies and trials assess as key objectives and outcomes the incidence, severity, prognostic indicators, and health impact of post-thrombotic syndrome, using validated measures.
DOI:
10.3324/haematol.2010.026989
URL:
https://www.ncbi.nlm.nih.gov/pubmed/20595095
Journal:
Haematologica
issn:
1592-8721 (Electronic)
Publication year:
2010
pages:
1952-9
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
Functional status:
Physical functioning
Age:
Children (0-18)
Disease:
Diseases of and symptoms related to the circulatory system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
7 - Observations
9 - Laboratory tests
Instrument:
Basic CEAP - Basic Clinical-Etiologic- Anatomic-Pathophysiologic
Manco-Johnson instrument
Villalta PTS scoring system-Pediatric modification