PS1578 EPIDEMIOLOGY AND RISK ASSESSMENT OF PEDIATRIC VENOUS THROMBOEMBOLISM IN KOREA
Authors: J.M. Lee, E.S. Park, H.S. Choi, K.‐S. Lee
Journal: HemaSphere (2019)

Background: Venous thromboembolism (VTE) is a condition that includes both severe venous thrombosis and pulmonary embolism, which is very rare in childhood. Nevertheless, it has been reported that the incidence has increased recently. With the development of treatment for severely children, the accurate diagnosis rate of thrombosis in pediatric patients is increasing as awareness of venous thrombosis increases. Risk factors that cause VTE in children include factors such as intravenous catheters, surgery, trauma, malignant tumors, and chronic inflammation conditions. It is also reported that in children VTE is the most prolific of age under the age of one and the second most common occurrence in adolescence. Aims: The purpose of this study is to identify risk factors for developing thrombosis in childhood cancers as well as other childhood diseases through the Korean Health Insurance Review and Assessment Service (HIRA) database. Methods: Data was extracted from HIRA data base. Using the HIRA database, all cases with any diagnostic code for VTE and age between 0 to 30 years old From Jan.1, 2007 to Dec.31, 2017 was 27592 cases. Children and young adults from 1 month to 29 years old were eligible for this study. Results: 21747 case of VTE was identified between January 2008 and December 2016. We found a bimodal age distribution of incidence of VTE in children and adolescent. The frequency of VTE occurs more often than under the age of one, and after the age of one, it tends to decrease rapidly and then gradually increase. The incidence of VTE is high in under 1 year old. After 1 year of age, it decreases sharply and gradually increases. VTE incidence rate for 0 to 1‐year‐olds was 20.15 per 100,000 persons. The incidence of VTE between 0–1 years is 10.23 times higher than that between 1–5 years. The ratio of males to females was 1.09, with males predominating Annual incidence of VTE is increased according to year. Age standardized annual incidence rate in 2008 is 9.98 per 100,000 population, 22.53 per 100,000 population. Age standardized annual incidence rate increased 2.25 times for 8 years. Age standardized annual incidence rate according to age group. incidence rate of 1–5 year group is similar between 2008 to 2016. The incidence of patients increased with age, and 26–29 years old group had the largest number of patients. The rate of increase in the incidence rate of patients was the highest in 16–20 years old group. Lower extremity was the most common site of venous thrombosis (n = 12608, 58%). The other unspecified site was the second most (12593, 45.6%), followed by lung(3696, 17.0%), portal vein, CNS, vena cava, and renal vein. Portal vein thrombosis was the most common site of VTE in children under 1 year of age, followed by other, lower extremity, CNS, lung, renal vein and vena cava. Summary/Conclusion: VTE is rare disease in children. However, incidence has increased recently. In this study, VTE incidence in population lower than 30‐years is 13/11 per 100,000 person in Korea. We found a bimodal age distribution of incidence of VTE in children and adolescent. The incidence of portal vein thrombosis is high in infant, infection and malignancy is most common comorbidity in VTE patient.