A final study by Agha et al retrospectively evaluated the incidence of PE in children (younger than 21 years of age) presenting to a pediatric emergency department and found it to be 2.1 per 100,000 visits.³ The median age of patients was 15 years, with 76 percent presenting with high-acuity Emergency Severity Index levels (1 and 2), suggesting the majority appeared clinically ill. The most common risk factors were a BMI 25 or above, oral contraceptive usage, and history of previous PE.

Summary

While pulmonary embolism may commonly be included in a practitioner’s differential diagnosis, PEs in children are extremely uncommon.

Dr. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington.

Dr. Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Poison Control Center at Upstate Medical University in Syracuse, New York.

References

1. Stein PD, Kayali F, Olson RE. Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey. J Pediatr. 2004;145(4):563-565.
2. van Ommen CH, Heijboer H, Büller HR, et al. Venous thromboembolism in childhood: a prospective two-year registry in the Netherlands. J Pediatr. 2001;139(5):676-681.
3. Agha BS, Sturm JJ, Simon HK, et al. Pulmonary embolism in the pediatric emergency department. Pediatrics. 2013;132(4):663-667.