RESUMO
BACKGROUND: The risk factors for central venous access device-related thrombosis (CRT) in children are not fully understood. We used evidence-based medicine to find the risk factors for CRT by pooling current studies reporting risk factors of CRT, aiming to guide clinical diagnosis and treatment. METHODS: A systematic search of PubMed, Web of Science, Embase, Cochrane Library, Scopus, CNKI, Sinomed, and Wanfang databases was conducted. RevMan 5.4 was employed for data analysis. RESULTS: The review included 47 studies evaluating 262,587 children with CVAD placement. Qualitative synthesis and quantitative meta-analysis identified D-dimer, location of insertion, type of catheter, number of lumens, catheter indwelling time, and central line-associated bloodstream infection as the most critical risk factors for CRT. Primarily due to observational design, the quality of evidence was regarded as low certainty for these risk factors according to the GRADE approach. CONCLUSION: Because fewer high-quality studies are available, larger sample sizes and well-designed prospective studies are still needed to clarify the risk factors affecting CRT. In the future, developing pediatric-specific CRT risk assessment tools is important. Appropriate stratified preventive strategies for CRT according to risk assessment level will help improve clinical efficiency, avoid the occurrence of CRT, and alleviate unnecessary suffering of children. IMPACT: This is the latest systematic review of risk factors and incidence of CRT in children. A total of 47 studies involving 262,587 patients were included in our meta-analysis, according to which the pooled prevalence of CRT was 9.1%. This study identified several of the most critical risk factors affecting CRT in children, including D-dimer, insertion location, type of catheter, number of lumens, catheter indwelling time, and central line-associated bloodstream infection (CLABSI).
RESUMO
PURPOSE: Cancer survivorship starts at diagnosis. Transition readiness is an important indicator for pediatric cancer survivors to move from pediatric to adult medical care. Appropriate measurement of transition readiness can facilitate better cancer survivorship. This study aimed to translate and validate of the English version of the TRANSITION-Q into Chinese. DESIGN AND METHODS: The translation followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) best-practice guidelines for the translation and cultural adaptation of patient-reported outcome measures (PROM). A cross- psychometric testing on reliability and validity were conducted from a convenient sample of Chinese adolescent cancer survivors aged 10-19 years. RESULTS: Two hundred seventy-one pediatric cancer patients were recruited for the psychometric validation. The 14-item Chinese TRANSITION-Q demonstrated adequate reliability. In exploratory factorial analyses and confirmatory factor analysis, a two-factor structure emerged with a variance of 54.78%, demonstrating construct validity. Convergent validity test showed TRANSITION-Q score was significantly positively correlated with self-efficacy (r = -0.84, p = 0.002). The known-group validity demonstrated the older group (age ≥14 years) had a significantly higher mean TRANSITION-Q score than the younger group (age < 14 years) (p = 0.04). CONCLUSION: The Chinese version of the TRANSITION-Q is reliable and valid and can be used in Chinese research and clinical settings. IMPLICATIONS FOR PRACTICE: This scale can be used in Chinese clinical and research settings to investigate understanding of transition readiness in Chinese pediatric cancer survivors.
