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Secondary Analysis of the Children's Healthcare Advancements in Thrombosis (CHAT) Consortium Dataset

Award Number: R21HL181655
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2028

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Secondary Analysis of the Children's Healthcare Advancements in Thrombosis (CHAT) Consortium Dataset - PROJECT SUMMARY/ABSTRACT Despite the 200% increased incidence of pediatric hospital associated-venous thromboembolism (HA-VTE), a blood clot in the venous or pulmonary vascular system, safe and efficacious prevention therapies have not been established. The current standard of care in pediatrics is to forego prevention therapies, such as pharmacologic prophylaxis, even in high-risk patients due to the potential bleeding risk. This concern is particularly relevant for children admitted to the intensive care unit (ICU), who represent one of the highest-risk groups for VTE development. Thus, there is a critical need to develop precision-based approaches to determine which children are at the highest HA-VTE risk for whom the benefits of thromboprophylaxis outweigh the potential bleeding risk. This study directly addresses this evidence gap by performing a secondary analysis of a Children’s Healthcare Advancements in Thrombosis (CHAT) Consortium dataset, CHAT 1901, to create a precision-based HA-VTE tool known as a risk assessment model (RAM) for critically ill children. The CHAT 1901 dataset contains extensive, prospective clinical and laboratory data on over 4,600 children admitted to a pediatric ICU at 32 centers in the U.S. The overall objective for this R21 application is to leverage the CHAT 1901 dataset to develop and validate complementary VTE and bleeding risk prediction models for critically ill children. The central hypothesis is that accurate identification of children at high VTE risk and low bleeding risk will enable safe, targeted enrollment and improved efficacy in future thromboprophylaxis trials. Aim 1 of this study is to update and internally validate a RAM for critically ill children utilizing the CHAT 1901 dataset. Predictors will be evaluated using multivariable Cox regression with imputation to address missing variables. Aim 2 is to identify predictors of hospital-associated bleeding among critically ill children utilizing the CHAT 1901 dataset. Bleeding risk variables will be assessed by univariate then multivariable Cox proportion hazards. Completion of these aims will create the first validated, precision-based risk prediction tool for both VTE and bleeding in critically ill children. Together, these models will allow clinicians and investigators to identify which children will benefit most from prophylactic anticoagulation while minimizing bleeding risk. By defining the optimal population for targeted thromboprophylaxis, this R21 will remove a key barrier that has limited prior pediatric studies and establish the foundation for a multicenter R01 trial evaluating the safety and efficacy of prophylactic anticoagulation. This work directly advances the NHLBI Strategic Vision by transforming pediatric hospital care from reactive management to proactive, individualized prevention and has the potential to significantly reduce VTE-related morbidity and mortality in hospitalized children nationwide.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $189,000 )
2026	2026	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	Blood Diseases and Resources Research	000	1	8/3/2026	NEW	$189,000
														Subtotal = $189,000

Grand Total All Awards = $189,000

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Secondary Analysis of the Children's Healthcare Advancements in Thrombosis (CHAT) Consortium Dataset

Award Number: R21HL181655

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2028

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