在患有癌症的儿科患者中,术后输血和传染性并发症
Elizabeth D Cochran1, Jillian C Jacobson1, Arti Machchhar1
1Department of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Children (Basel, Switzerland)
|February 26, 2025
概括
在外科手术期间输血增加了儿童癌症手术患者的感染并发症和死亡率. 仔细考虑输血风险与益处对这一脆弱人群至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 手术瘤学手术瘤学
- 输血医学 输血医学
背景情况:
- 术后输血是成人癌症患者术后感染的已知危险因素.
- 术前输血与儿童癌症患者的传染性并发症之间的关联此前尚不清楚.
研究的目的:
- 在患有癌症的儿科患者中,研究术前输血和术后传染性并发症之间的关联.
- 确定外科手术前输血是否是该人群中不良结果的独立风险因素.
主要方法:
- 美国外科医生学院国家外科质量改善计划儿科 (NSQIP-P) 数据库 (2015-2019) 的回顾性分析.
- 包括接受手术的患有活跃癌症的儿科患者.
- 使用千平方,费舍尔精确测试和多变量逻辑回归的统计分析.
主要成果:
- 分析了14,973名儿童癌症患者;17.4%接受了手术前输血 (PBT).
- PBT与多种术后传染性并发症 (手术部位感染,肺炎,尿道感染,C. difficile,CLABSI,败血症) 的显著更高的发病率和30天死亡率的增加有关.
- 多变量分析证实PBT是感染并发症 (OR 1.9) 和死亡 (OR 1.8) 的独立风险因素.
结论:
- 接受PBT手术的儿童癌症患者面临手术后感染和30天死亡的风险.
- 鉴于该人群的基线免疫抑制,输血后的感染可能特别严重.
- 对输血风险和益处的审慎评估对于儿科癌症患者至关重要.
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