Independent Risk Factors for RBC Transfusion in Children Undergoing Surgery. Analysis of 14,248 Cases at a German University Hospital
Abstract
:1. Introduction
2. Materials and Methods
2.1. Aim
2.2. Data Acquisition
2.3. Patient Inclusion and Exclusion Criteria
2.4. Statistics
3. Results
3.1. Patients’ Characteristics
3.2. RBC Transfusion
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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RBC-Transfusion n (%) 1439 (10.1%) | Non-RBC-Transfusion n (%) 12,809 (89.9%) | p-Value | |
---|---|---|---|
Patient characteristics | |||
Gender male | 55.9% (53.3–58.5%); n = 805 | 61.3% (60.4–62.1%); n = 7846 | <0.001 |
Age (years) | 4.9 (±0.1), 2.0 (0.0; 9.0) | 6.4 (±0.0), 5.0 (1.0; 11.0) | <0.001 |
Proportion of Age groups | <0.001 | ||
0 | 38.6%; n = 555 | 17.5%; n = 2240 | |
1–4 | 21.3%; n = 307 | 29.9%; n = 3829 | |
5–9 | 15.3%; n = 220 | 21.8%; n = 2796 | |
10–14 | 15.0%; n = 216 | 17.5%; n = 2242 | |
15–17 | 9.8%; n = 141 | 13.3%; n = 1702 | |
Type of surgery | |||
Proportion of surgery groups | <0.001 | ||
Dermatology, Ophthalmology | 3.4%; n = 49 | 12.2%; n = 1567 | |
Neurosurgery | 10.0%; n = 144 | 3.1%; n = 401 | |
Otorhinolaryngology | 1.3%; n = 19 | 32.0%; n = 4096 | |
Thoracic surgery | 0.7%; n = 10 | 0.4%; n = 55 | |
Cardiac surgery | 2.0%; n = 29 | 0.3%; n = 44 | |
Vascular surgery | 16.5%; n = 238 | 5.4%; n = 697 | |
Visceral and endocrine surgery | 18.7%; n = 269 | 12.7%; n = 1621 | |
Urology | 1.0%; n = 15 | 6.2%; n = 796 | |
Gynaecology | 0.3%; n = 5 | 0.7%; n = 84 | |
Obstetric | 0.1%; n = 1 | 0.4%; n = 52 | |
Oral-maxillofacial surgery | 0.0%; n = 0 | 1.4%; n = 178 | |
Trauma and orthopaedic surgery | 1.3%; n = 18 | 11.0%; n = 1403 | |
Haematopoietic and lymphatic system | 18.8%; n = 271 | 1.5%; n = 194 | |
Mixed group | 25.8%; n = 371 | 12.7%; n = 1621 |
Risk Factor | Univariate Analysis | Multivariate Analysis |
---|---|---|
p-Value | p-Value; OR (with 95% CI) | |
Gender | <0.001 | p = 0.036; OR = 1.19 (1.01–1.39) (female compared to male) |
Age (years) 0 1–4 5–9 10–14 15–17 | <0.001 | (all compared to age 0) p < 0.001; OR = 0.28 (0.20–0.38) p < 0.001; OR = 0.21 (0.15–0.30) p < 0.001; OR = 0.18 (0.13–0.26) p < 0.001; OR = 0.14 (0.10–0.21) |
Anaemia at admission Anaemia No anaemia Unknown 1 | <0.001 | p < 0.001; OR = 15.10 (11.58–19.90) p < 0.001; OR = 2.40 (1.76–3.30) (all compared to unknown) |
Type of surgery Dermatology, Ophthalmology Neurosurgery Otorhinolaryngology Thoracic surgery Cardiac surgery Vascular surgery Visceral and endocrine surgery Urology Gynaecology Obstetric Oral-maxillofacial surgery Trauma and orthopaedic surgery Haematopoietic and lymphatic system Mixed group | <0.001 | (all compared to Derm. and Oph.) p < 0.001; OR = 10.14 (6.48–16.19) p < 0.001; OR = 0.29 (0.15–0.53) p = 0.598; OR = 1.31 (0.46–3.36) p < 0.001; OR = 4.79 (2.05–11.04) p < 0.001; OR = 9.93 (6.48–15.59) p < 0.001; OR = 2.48 (1.64–3.83) p = 0.676; OR = 1.17 (0.55–2.35) p = 0.014; OR = 3.64 (1.16–9.51) p = 0.559; OR = 0.55 (0.03–2.71) p = 0.963; OR = 0.00 (0.00–0.00) p = 0.669; OR = 1.15 (0.60–2.13) p < 0.001; OR = 36.98 (23.51–59.41) p < 0.001; OR = 5.86 (3.91–8.99) |
Sepsis/SIRS 2 | <0.001 | p < 0.001; OR = 10.16 (6.98–15.07) |
Respiratory dysfunction | <0.001 | p < 0.001; OR = 7.56 (6.01–9.52) |
Cardiovascular dysfunction | <0.001 | p < 0.001; OR = 4.68 (3.43–6.40) |
Neurological dysfunction | <0.001 | p = 0.029, OR = 1.77 (1.06–2.97) |
Renal dysfunction | <0.001 | p < 0.001; OR = 16.17 (8.33–33.55) |
Hepatic dysfunction | <0.001 | p = 0.988; OR = 5.58 × 106 (0.00–∞) 3 |
Hb Values and Transfusion Rates | RBC-Transfusion n (%) 1439 (10.1%) | Non-RBC-Transfusion n (%) 12,809 (89.9%) | p-Value |
---|---|---|---|
Hb value at admission (g/dL) | 10.9 (±0.1), 10.3 (8.4; 12.7) | 12.6 (±0.0), 12.5 (11.1; 13.7) | <0.001 |
Anaemia rate at admission | 82.4% (79.6–85.0%); n = 661 | 29.6% (28.0–31.2%); n = 963 | <0.001 |
Proportion of anaemia groups at admission | <0.001 | ||
Anaemia at admission (%) | 45.9%; n = 661 | 7.5%; n = 963 | |
No anaemia at admission (%) | 9.8%; n = 141 | 17.9%; n = 2291 | |
Unknown anaemia status at admission 1 | 44.3%; n = 637 | 74.6%; n = 9555 | |
Hb value at discharge (g/dL) | 10.1 (±0.1), 9.8 (8.7; 11.3) | 12.3 (±0.0), 12.3 (11.2; 13.3) | <0.001 |
Anaemia rate at discharge | 87.9% (85.4–90.1%); n = 711 | 25.6% (24.4–26.8%); n = 1393 | <0.001 |
Proportion of anaemia groups at discharge | <0.001 | ||
Anaemia at discharge | 49.4%; n = 711 | 10.9%; n = 1393 | |
No anaemia at discharge | 6.8%; n = 98 | 31.6%; n = 4052 | |
Unknown anaemia status at discharge | 43.8%; n = 630 | 57.5%; n = 7364 | |
Platelet transfusion rate | 47.9% (45.3–50.6%); n = 690 | 0.7% (0.5–0.8%); n = 87 | <0.001 |
FFP 2 transfusion rate | 30.6% (28.2–33.0%); n = 440 | 0.4% (0.3–0.5%); n = 45 | <0.001 |
Fibrinogen transfusion rate | 3.3% (2.4–4.3%); n = 47 | 0.0% (0.0–0.1%); n = 5 | <0.001 |
PCC 3 transfusion rate | 3.3% (2.4–4.3%); n = 47 | 0.1% (0.1–0.2%); n = 19 | <0.001 |
Complications | RBC-Transfusion n (%) 1439 (10.1%) | Non-RBC-Transfusion n (%) 12,809 (89.9%) | p-Value |
---|---|---|---|
Sepsis/SIRS 1 | 23.6% (21.4–25.8%); n = 339 | 0.4% (0.3–0.5%); n = 45 | <0.001 |
Respiratory dysfunction | 41.2% (38.7–43.8%); n = 593 | 2.7% (2.4–3.0%); n = 342 | <0.001 |
Cardiovascular dysfunction | 24.5% (22.3–26.8%); n = 353 | 1.0% (0.9–1.2%); n = 132 | <0.001 |
Neurological dysfunction | 4.8% (3.7–6.0%); n = 69 | 0.5% (0.3–0.6%); n = 58 | <0.001 |
Renal dysfunction | 11.7% (10.1–13.4%); n = 168 | 0.1% (0.1–0.2%); n = 14 | <0.001 |
Hepatic dysfunction | 0.6% (0.2–1.1%); n = 8 | 0.0% (0.0–0.0%); n = 0 | <0.001 |
Mortality | 7.1% (5.8–8.5%); n = 102 | 0.1% (0.0–0.1%); n = 9 | <0.001 |
Hospital LOS 2 (days) | 42.0 (± 1.1), 32.0 (13.0; 53.0) | 4.4 (± 0.1), 2.0 (1.0; 4.0) | <0.001 |
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Piekarski, F.; Neef, V.; Meybohm, P.; Rolle, U.; Schneider, W.; Zacharowski, K.; Schmitt, E. Independent Risk Factors for RBC Transfusion in Children Undergoing Surgery. Analysis of 14,248 Cases at a German University Hospital. Children 2021, 8, 634. https://doi.org/10.3390/children8080634
Piekarski F, Neef V, Meybohm P, Rolle U, Schneider W, Zacharowski K, Schmitt E. Independent Risk Factors for RBC Transfusion in Children Undergoing Surgery. Analysis of 14,248 Cases at a German University Hospital. Children. 2021; 8(8):634. https://doi.org/10.3390/children8080634
Chicago/Turabian StylePiekarski, Florian, Vanessa Neef, Patrick Meybohm, Udo Rolle, Wilfried Schneider, Kai Zacharowski, and Elke Schmitt. 2021. "Independent Risk Factors for RBC Transfusion in Children Undergoing Surgery. Analysis of 14,248 Cases at a German University Hospital" Children 8, no. 8: 634. https://doi.org/10.3390/children8080634