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Long-term survival rate of pediatric patients after blood transfusion
France Gauvin1, Martin A Champagne, Pierre Robillard
1Pediatric Intensive Care Unit, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada. france_gauvin@ssss.gouv.qc.ca
Insights
Pediatric posttransfusion survival rates are higher than in adults, with most deaths occurring early. Key risk factors for mortality in children include young age, malignant disease, and multiple transfusions.
Area of Science:
- Pediatric Hematology
- Transfusion Medicine
- Clinical Outcomes Research
Background:
- Adult posttransfusion survival rates (PTSR) range from 41-67% at 1-10 years.
- Limited data exists on PTSR specifically in pediatric populations.
- This study addresses PTSR and mortality risk factors in children receiving transfusions.
Purpose of the Study:
- To evaluate posttransfusion survival rates in pediatric patients.
- To identify risk factors associated with death in children undergoing transfusions.
- To compare pediatric PTSR with previously reported adult data.
Main Methods:
- Retrospective analysis of 1100 children receiving their first transfusion between 1990-1992.
- Data collected included demographics, diagnoses, surgical procedures, and transfusion details.
- Death confirmation utilized hospital, provincial, and death certificate databases.
Main Results:
- 1-year PTSR was 86.9%, and 10-year PTSR was 82.3%.
- Median survival for non-survivors was 22 days.
- Risk factors for mortality included age <1 month, malignant disease, >20 transfusions, and multiple component types.
Conclusions:
- Pediatric PTSR is significantly higher than in adults.
- Mortality risk is concentrated in the early post-transfusion period.
- Survival rates stabilize after the initial period following transfusion.
Background:
Studies in adults report posttransfusion survival rate (PTSR) at 1 to 10 years of 41 to 67 percent. There are no published studies specifically addressing PTSR in pediatric patients. The objectives of this study were to evaluate PTSR and risk factors associated with death in children receiving transfusions.
Study Design And Methods:
A database of all patients receiving their first transfusion between 1990 and 1992 at Sainte-Justine Hospital (SJH) was used. Patients' demographic data, primary diagnosis, surgical procedures, and information on all labile components transfused were collected. Death was confirmed by the SJH database, RAMQ (universal health care provider for Québec residents), and the Quebec Commission for Access to Information (death certificate).
Results:
The study population consisted of 1100 children. Median age was 16 months (range, 0-204 months). The most frequent primary diagnoses were cardiac disease (22%), prematurity (21.5%), malignant disease (11%), and hematologic disease (9.5%). Patients received a median of three transfusions (range, 1-126). PTSR was 86.9 percent at 1 year and 82.3 percent at 10 years. For nonsurvivors, median survival time was 22 days. Multivariate analysis showed that significant risk factors for death are age of less than 1 month, a diagnosis of malignant disease, more than 20 transfusions, and administration of more than one type of blood component.
Conclusion:
PTSR in children receiving their first transfusion between 1990 and 1992 was considerably higher than the PTSR reported in adults. Death occurred early after the first transfusion; survival rate remained relatively stable thereafter.
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