International Journal of Molecular Medical Science, 2025, Vol.15, No.2, 54-68 http://medscipublisher.com/index.php/ijmms 66 of inflammatory markers combined with clinical variables to avoid misjudgment. ⑤Attach importance to obesity assessment, and jointly develop intervention programs for children with obesity. In short, clinical staff should be alert to the synergistic effect of multiple risk factors, and accurately prevent and manage VTE in children according to regionalized and age-stratified strategies to ensure the health of children. 5 Conclusion This systematic review and meta-analysis comprehensively evaluated the predictive efficacy and heterogeneity of venous thromboembolism (VTE) risk prediction models in children. The pooled AUC of 0.84 (95% CI: 0.80~0.88) demonstrated moderate-to-good discriminative performance across existing models, predominantly based on logistic regression, with central venous catheter (CVC) as the most frequent predictor. However, significant heterogeneity (I²=96%) was observed, driven by variability in predictor selection, regional differences in medical practices, and insufficient adjustment for age stratification. Seven studies exhibited a high risk of bias, primarily due to opaque handling of missing data and lack of blinding in predictor-outcome assessments. The proposed "core + extended" model architecture integrates age-specific biomarker thresholds (e.g., D-dimer, CRP) vertically and cross-regional core variables (≤5 items) horizontally, aiming to harmonize accuracy with clinical applicability. Future research should prioritize multicenter cohorts to validate dynamic biomarkers and machine learning algorithms, address regional disparities in predictor relevance (e.g., CVC in low-resource settings), and refine age-stratified strategies for neonates and adolescents. Clinical recommendations emphasize judicious CVC use, obesity assessment, and dynamic monitoring of inflammatory markers. By addressing these gaps, future models can enhance precision while maintaining generalizability, ultimately improving VTE prevention and management in pediatric populations. Acknowledgement We would like to thank Professor Yang Li, Professor Xin Zhang and Professor Yeli Huang for their guidance and inspiration on the topic selection, ideas, views and demonstration of this research. We thank Peking Union Medical College for supporting this study. Conflict of Interest Disclosure The authors affirm that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest. References Biss T., Alikhan R., Payne J., Alamelu J., Williams M., Richards M., Mathias M., Tunstall O., and Chalmers E., 2016, Venous thromboembolism occurring during adolescence, Archives of Disease in Childhood, 101(5): 427-432. https://doi.org/10.1136/archdischild-2015-309875 Biss T.T., 2016, Venous thromboembolism in children: is it preventable?, Seminars in Thrombosis and Hemostasis, 42(6): 603-611. https://doi.org/10.1055/s-0036-1581100 Cairo S.B., Lautz T.B., Schaefer B.A., Yu G., and Rothstein D.H., 2018, Risk factors for venous thromboembolic events in pediatric surgical patients: defining indications for prophylaxis, Journal of Pediatric Surgery, 53(10): 1996-2002. https://doi.org/10.1016/j.jpedsurg.2017.12.016 Chalmers E., Ganesen V., Liesner R., Maroo S., Nokes T., Saunders D., and Williams M., 2011, Guideline on the investigation, management and prevention of venous thrombosis in children, British Journal of Haematology, 154(2): 196-207. https://doi.org/10.1111/j.1365-2141.2010.08543.x Connelly C.R., Laird A., Barton J.S., Fischer P.E., Krishnaswami S., Schreiber M.A., Zonies D.H., and Watters J.M., 2016, A clinical tool for the prediction of venous thromboembolism in pediatric trauma patients, JAMA Surgery, 151(1): 50-57. https://doi.org/10.1001/jamasurg.2015.2670 Cui Y., and Zhang Y.X., eds., 2021, Pediatric Nursing (7th ed.), People's Medical Publishing House, Beijing, China, pp. 442. Fort P., Beg K., Betensky M., Kiskaddon A., and Goldenberg N.A., 2022, Venous thromboembolism in premature neonates, Seminars in Thrombosis and Hemostasis, 48(4): 422-433. https://doi.org/10.1055/s-0041-1740267 Halvorson E.E., Ervin S.E., Russell T.B., Skelton J.A., Davis S., and Spangler J., 2016, Association of obesity and pediatric venous thromboembolism, Hospital Pediatrics, 6(1): 22-26. https://doi.org/10.1542/hpeds.2015-0039
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