Versiti Blood Research Institute Articles
Understanding What Causes Blood Clots in Children Who Are Hospitalized
Associate Investigator Brian Branchford, MD, is working to evaluate the risk of clotting in pediatric patients and provide new treatment options.
According to the National Blood Clot Alliance, as many as 1 in 200 children will develop a blood clot while hospitalized. Versiti Blood Research Institute (BRI) Associate Investigator Brian Branchford, MD, has focused his career on researching better treatments for these patients. After completing his residency at the Medical College of Wisconsin and working in the lab of BRI Senior Investigator Robert Montgomery, MD, he conducted research and treated patients at Children’s Hospital of Colorado before returning to Versiti in 2020.
Research beginnings in Colorado
Dr. Branchford’s interest in hematology and pediatric medicine initially led him to Colorado for “their great clinical program in bleeding and clotting disorders,” he said. During his time there, he was approached by the hospital to develop better processes and treatments for patients who develop blood clots. “In 2008, we got a call to action from the U.S. Surgeon General who said that venous thromboembolism is one of the hospital-acquired conditions that shouldn’t happen, and we needed to reduce its incidence,” he said.
Medicare and Medicaid would not cover these treatments, so hospitals were tasked with reducing this and other hospital-acquired conditions like ventilator-associated pneumonia and catheter-related bloodstream infections. “I was tasked with reducing the incidence of these conditions in hospitals,” Dr. Branchford said, “but we didn’t really know why they were happening in the first place.”
After conducting a small study and conferring with colleagues, they developed a national registry with 1,200-1,500 children who have developed clots during hospital stays. These patients’ information, including medical history and admission diagnosis, have helped Dr. Branchford and his colleagues create the first large, multi-institutional, pediatric cohort used to develop a risk-assessment model. “Now, we’re in a position where we have about 15 hospitals across the country that are part of the Children’s Hospital Acquired Thrombosis (CHAT) consortium,” he said.
Continuing his work at Versiti Blood Research Institute
Since arriving at Versiti, Dr. Branchford has been recruiting and enrolling patients to help validate his risk-assessment model. About 20 hospitals are expected to participate by collecting blood samples from patients to look for biomarkers for clot formation, which may help physicians earlier identify patients at risk for developing clots. By investigating a combination of clinical and lab markers, Dr. Branchford and his colleagues hope to identify which patients are at a higher risk for developing blood clots and which treatments are best suited to them.
“The long-term goal is to determine who’s high-risk and who’s low-risk for a randomized control trial of a particular treatment strategy, from compression socks to blood thinners,” he said. Having a variety of hospitals across the country participating is key: “I like the ability to work collaboratively with other centers. It’s essential to do that in pediatric thrombosis studies where it happens enough to be a problem, but it would take decades to get enough information from one center to make a difference.”
His approach to research
In order to evaluate the risk of clotting in patients, Dr. Branchford plans to look at the mechanisms behind clot formation, particularly inflammation. He is interested in understanding the physiological connection between a state of inflammation and clot formation, with a goal of safely interrupting that interaction and providing better treatment options for patients. “Clinical research can inform my basic research, and basic research can inform my clinical research,” he said. “That’s what’s nice about my position as a clinician and a researcher; I can take what I see in the hospital back to the lab.”
In Colorado, Dr. Branchford was one of a small number of people who conducted non-malignant hematology research and often consulted peers at other research institutions. For that reason, he feels that the critical mass of expertise at the BRI makes it the perfect place to conduct his work. “Versiti is a world-class institution,” he said. “I understand the reputation Versiti has, and it’s excellent. It is easily one of the top few institutions of its kind in the U.S., if not the world.”
He looks forward to developing deeper working relationships with a variety of Versiti experts, including Associate Investigator Lisa Baumann Kreuziger, MD, MS; Assistant Investigator Lynn Malec, MD, MSc; and Vice President for Research Peter Newman, PhD. “There’s an embarrassment of riches for inspiration, brainstorming and troubleshooting,” Dr. Branchford said. “Versiti has deep expertise in blood research. I have world experts in different areas right here, who I can consult with. I can’t think of another place in the world that can do that.”
About the expert: Brian Branchford, MD, is an associate medical director at Versiti Medical Sciences Institute; associate investigator at Versiti Blood Research Institute; and assistant professor in the Department of Pediatrics at the Medical College of Wisconsin.