Abstract

Blood transfusion risks have been studied extensively, but data regarding appropriate use of transfusion and survival on hospitalized children are unknown. The purpose of this study was to determine the association between appropriate use of transfusion in children and in-hospital mortality. It was a prospective cohort study. Appropriateness of blood transfusion was evaluated using American Association of Blood Bank Pediatric Hemotherapy. This research was carried out in "Dr. Jorge Lizarraga", Children's Hospital Valencia, Venezuela from January 2002 until September 2003. The main outcome measure was death during hospitalization. 617 children (< 15 years old, male = 57%) were evaluated. Appropriateness was 81.2% (501/617). For non appropriate transfusion group, incidence rate (IR) of in-hospital mortality was 7 per 1,000 while IR for appropriate transfusion group 3.6 per 1,000; IR ratio was 1.98 (95% CI= 1.1 to 3.7, p = 0.01). Crude hazard ratio (HR) was 2 (95% CI = 1.2 to 3.5). In patients > 1 year old, HR was 4.4 (95% CI = 1.39 to 13.6, p= 0.01); in patients < 1 year old, HR was 1.5 (95% CI = 0.79 to 2.9, p = 0.2). Conclusion: Inappropriate transfusion in hospitalized children is associated with an increased risk of in-hospital mortality. Educational efforts addressing appropriate use of blood component should be increased. Further studies about association between transfusion and mortality are needed.