Effectiveness of blood transfusions and risk factors for mortality in children aged from 1 month to 4 years at the Bon Marché Hospital, Bunia, Democratic Republic of the Congo.
Details
Request a copy Under indefinite embargo.
UNIL restricted access
State: Public
Version: Final published version
UNIL restricted access
State: Public
Version: Final published version
Serval ID
serval:BIB_BFCBF634CD4E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effectiveness of blood transfusions and risk factors for mortality in children aged from 1 month to 4 years at the Bon Marché Hospital, Bunia, Democratic Republic of the Congo.
Journal
Tropical medicine & international health : TM & IH
ISSN
1365-3156 (Electronic)
ISSN-L
1360-2276
Publication state
Published
Issued date
12/2012
Peer-reviewed
Oui
Volume
17
Number
12
Pages
1457-1464
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To assess the effectiveness of blood transfusions in a hospital of north-eastern Democratic Republic of the Congo.
Prospective study of children admitted for severe anaemia. During admission, data were collected on clinical condition and haemoglobin levels, before and after blood transfusion. A linear regression model was built to explore factors associated with haemoglobin level after transfusion. Risk factors for mortality were explored through multivariate logistic regression.
Haemoglobin level (Hb) was below 4 g/dl in 35% (230/657), between 4 and 6 g/dl in 58% (348/657) and at least 6 g/dl in another 6% (43/657) of the transfused children. A transfusion of 15 ml/kg of whole blood increased the Hb from 4.4 to 7.8 g/dl. Haemoglobin level after transfusion was associated with baseline Hb, quantity of delivered blood and history of previous transfusions. Overall case-fatality rate was 5.6% (37/657). Risk factors for deaths were co-morbidities such as chest infection, meningitis or malnutrition, Hb ≥ 6 g/dl, impaired consciousness or jugular venous distention on admission, and provenance.
Transfusion was a frequent practice, the use of which could clearly have been rationalised. While indications should be restricted, quantities of transfused blood should be adapted to needs.
Prospective study of children admitted for severe anaemia. During admission, data were collected on clinical condition and haemoglobin levels, before and after blood transfusion. A linear regression model was built to explore factors associated with haemoglobin level after transfusion. Risk factors for mortality were explored through multivariate logistic regression.
Haemoglobin level (Hb) was below 4 g/dl in 35% (230/657), between 4 and 6 g/dl in 58% (348/657) and at least 6 g/dl in another 6% (43/657) of the transfused children. A transfusion of 15 ml/kg of whole blood increased the Hb from 4.4 to 7.8 g/dl. Haemoglobin level after transfusion was associated with baseline Hb, quantity of delivered blood and history of previous transfusions. Overall case-fatality rate was 5.6% (37/657). Risk factors for deaths were co-morbidities such as chest infection, meningitis or malnutrition, Hb ≥ 6 g/dl, impaired consciousness or jugular venous distention on admission, and provenance.
Transfusion was a frequent practice, the use of which could clearly have been rationalised. While indications should be restricted, quantities of transfused blood should be adapted to needs.
Keywords
Anemia/mortality, Anemia/therapy, Blood Transfusion/adverse effects, Child, Preschool, Comorbidity, Democratic Republic of the Congo/epidemiology, Female, Hemoglobins/metabolism, Hospital Mortality, Humans, Infant, Linear Models, Logistic Models, Male, Multivariate Analysis, Prospective Studies, Risk Factors
Pubmed
Open Access
Yes
Create date
23/02/2016 19:14
Last modification date
20/08/2019 16:34