{
  "abstract": "Objectives Pulmonary thromboembolism (PTE) is rare but potentially life-threatening in children and differs substantially from adult PTE in epidemiology and risk factors. We conducted a systematic review and meta-analysis to summarise the epidemiology, clinical characteristics and risk factors of paediatric PTE.Design A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Data sources We searched eight databases (PubMed, Embase (Ovid), MEDLINE (Ovid), Cochrane Library and four Chinese databases) on 2 March 2023, with an updated search on 2 July 2024.Eligibility criteria We included original studies reporting epidemiology (incidence/prevalence, major clinical outcomes and long-term sequelae), clinical characteristics, or risk factors of PTE in patients younger than 18 years. Reviews, case reports/series without extractable epidemiological data and studies not focused on paediatric PTE were excluded.Data extraction and synthesis Two reviewers independently screened studies, extracted data and assessed risk of bias using appropriate tools for observational studies. A random-effects model was applied to pool prevalence and incidence estimates, along with related outcomes, and their 95% CIs, regardless of the degree of heterogeneity.Results From 14 438 records, 26 studies were included: 16 cross-sectional, 9 cohort and 1 case–control study. 23 studies were marked as high quality and three as moderate quality. The pooled incidence of paediatric PTE was 0.016% (95% CI 0.0011% to 0.0298%). Autopsy-confirmed prevalence was 5.29% (95% CI 1.28% to 9.30%). Case fatality was 4.04% (95% CI 0.49% to 7.58%), and recurrence was 26.31% (95% CI 19.62% to 33.01%). Available evidence suggested an increasing trend in PTE occurrence over recent years. Female sex and oral contraceptive use were frequently reported clinical characteristics in adolescents. Reported risk factors clustered into genetic predisposition, underlying diseases, immobilisation or surgery and central venous catheter-related thrombosis.Conclusions Paediatric PTE remains uncommon but appears to be increasing, with notable recurrence and non-negligible fatality. Given heterogeneous study settings and definitions, further high-quality, population-based studies are needed to refine epidemiological estimates and clarify age-specific risk profiles, thereby informing prevention strategies and clinical management.Trial registration number PREPARE-2023CN922.",
  "authors": [
    {
      "affiliations": [
        "Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University",
        "Children's Medicine Key Laboratory of Sichuan Province, Chengdu, China",
        "NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China",
        "West China School of Medicine, Sichuan University, Chengdu, Sichuan, China",
        "Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China"
      ],
      "name": "Jianing Liu"
    },
    {
      "affiliations": [
        "Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University",
        "Children's Medicine Key Laboratory of Sichuan Province, Chengdu, China",
        "NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China",
        "West China School of Medicine, Sichuan University, Chengdu, Sichuan, China",
        "West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Xiaofeng Ni"
    },
    {
      "affiliations": [
        "Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University",
        "Children's Medicine Key Laboratory of Sichuan Province, Chengdu, China",
        "NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China",
        "West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Linan Zeng"
    },
    {
      "affiliations": [
        "Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University",
        "Children's Medicine Key Laboratory of Sichuan Province, Chengdu, China",
        "NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China",
        "West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Xia Song"
    },
    {
      "affiliations": [
        "Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University",
        "Children's Medicine Key Laboratory of Sichuan Province, Chengdu, China",
        "NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China"
      ],
      "name": "Sha Diao"
    },
    {
      "affiliations": [
        "Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China"
      ],
      "name": "Lina Chen"
    },
    {
      "affiliations": [
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China",
        "Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China",
        "NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China",
        "The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital，Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children’s Health, West China Second University Hospital, Sichuan University, Chengdu, China",
        "Sichuan Birth Defects Clinical Research Center，West China Second University Hospital, Sichuan University, Chengdu, China"
      ],
      "name": "Hanmin Liu"
    },
    {
      "affiliations": [
        "Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University",
        "Children's Medicine Key Laboratory of Sichuan Province, Chengdu, China",
        "NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China",
        "Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China",
        "Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China",
        "West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Lingli Zhang"
    }
  ],
  "title": "Epidemiological characteristics of pulmonary thromboembolism in children: a systematic review and meta-analysis",
  "uid": "164453c7-9226-5c82-b2a4-a62f8c125232"
}