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Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma

Although transfusion is a primary life-saving technique, the assessment of transfusion requirements in children with trauma at an early stage is challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma. This was a case–control study that emplo...

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Autores principales: Komori, Akira, Iriyama, Hiroki, Aoki, Makoto, Deshpande, Gautam A., Saitoh, Daizoh, Naito, Toshio, Abe, Toshikazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939166/
https://www.ncbi.nlm.nih.gov/pubmed/33655972
http://dx.doi.org/10.1097/MD.0000000000025014
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author Komori, Akira
Iriyama, Hiroki
Aoki, Makoto
Deshpande, Gautam A.
Saitoh, Daizoh
Naito, Toshio
Abe, Toshikazu
author_facet Komori, Akira
Iriyama, Hiroki
Aoki, Makoto
Deshpande, Gautam A.
Saitoh, Daizoh
Naito, Toshio
Abe, Toshikazu
author_sort Komori, Akira
collection PubMed
description Although transfusion is a primary life-saving technique, the assessment of transfusion requirements in children with trauma at an early stage is challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma. This was a case–control study that employed a nationwide registry of patients with trauma (Japan Trauma Data Bank) and included patients aged <16 years with blunt trauma between 2004 and 2015. An assessment of blood consumption score for pediatrics (ped-ABC score) was developed based on previous literatures and clinical relevance. One point was assigned for each of the following criteria: systolic blood pressure ≤90 mm Hg, heart rate ≥120/min, Glasgow coma scale (GCS) score <15, and positive focused assessment with sonography for trauma (FAST) scan. For sensitivity analysis, we assessed age-adjusted ped-ABC scores using cutoff points for different ages. Among 5943 pediatric patients with trauma, 540 patients had transfusion within 24 hours after trauma. The in-hospital mortality rate was 2.6% (145/5615). The transfusion rate increased from 7.6% (430/5631) to 35.3% (110/312) in patients with systolic blood pressure ≤90 mm Hg (1 point), from 6.1% (276/4504) to 18.3% (264/1439) in patients with heart rate ≥120/min (1 point), from 4.1% (130/3198) to 14.9% (410/2745) in patients with disturbance of consciousness with GCS score <15 (1 point), and from 7.4% (400/5380) to 24.9% (140/563) in patients with positive FAST scan (1 point). Ped-ABC scores of 0, 1, 2, 3, and 4 points were associated with transfusion rates of 2.2% (48/2210), 7.5% (198/2628), 19.8% (181/912), 53.3% (88/165), and 89.3% (25/28), respectively. After age adjustment, c-statistic was 0.76 (95% confidence interval, 0.74–0.78). The ped-ABC score using vital signs and FAST scan may be helpful in predicting the requirement for transfusion within 24 hours in children with trauma.
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spelling pubmed-79391662021-03-08 Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma Komori, Akira Iriyama, Hiroki Aoki, Makoto Deshpande, Gautam A. Saitoh, Daizoh Naito, Toshio Abe, Toshikazu Medicine (Baltimore) 3900 Although transfusion is a primary life-saving technique, the assessment of transfusion requirements in children with trauma at an early stage is challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma. This was a case–control study that employed a nationwide registry of patients with trauma (Japan Trauma Data Bank) and included patients aged <16 years with blunt trauma between 2004 and 2015. An assessment of blood consumption score for pediatrics (ped-ABC score) was developed based on previous literatures and clinical relevance. One point was assigned for each of the following criteria: systolic blood pressure ≤90 mm Hg, heart rate ≥120/min, Glasgow coma scale (GCS) score <15, and positive focused assessment with sonography for trauma (FAST) scan. For sensitivity analysis, we assessed age-adjusted ped-ABC scores using cutoff points for different ages. Among 5943 pediatric patients with trauma, 540 patients had transfusion within 24 hours after trauma. The in-hospital mortality rate was 2.6% (145/5615). The transfusion rate increased from 7.6% (430/5631) to 35.3% (110/312) in patients with systolic blood pressure ≤90 mm Hg (1 point), from 6.1% (276/4504) to 18.3% (264/1439) in patients with heart rate ≥120/min (1 point), from 4.1% (130/3198) to 14.9% (410/2745) in patients with disturbance of consciousness with GCS score <15 (1 point), and from 7.4% (400/5380) to 24.9% (140/563) in patients with positive FAST scan (1 point). Ped-ABC scores of 0, 1, 2, 3, and 4 points were associated with transfusion rates of 2.2% (48/2210), 7.5% (198/2628), 19.8% (181/912), 53.3% (88/165), and 89.3% (25/28), respectively. After age adjustment, c-statistic was 0.76 (95% confidence interval, 0.74–0.78). The ped-ABC score using vital signs and FAST scan may be helpful in predicting the requirement for transfusion within 24 hours in children with trauma. Lippincott Williams & Wilkins 2021-03-05 /pmc/articles/PMC7939166/ /pubmed/33655972 http://dx.doi.org/10.1097/MD.0000000000025014 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 3900
Komori, Akira
Iriyama, Hiroki
Aoki, Makoto
Deshpande, Gautam A.
Saitoh, Daizoh
Naito, Toshio
Abe, Toshikazu
Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
title Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
title_full Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
title_fullStr Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
title_full_unstemmed Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
title_short Assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
title_sort assessment of blood consumption score for pediatrics predicts transfusion requirements for children with trauma
topic 3900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939166/
https://www.ncbi.nlm.nih.gov/pubmed/33655972
http://dx.doi.org/10.1097/MD.0000000000025014
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