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

ABSTRACT:

Abstract

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.

SUBMITTER: Komori A

PROVIDER: S-EPMC7939166 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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

Komori Akira A Iriyama Hiroki H Aoki Makoto M Deshpande Gautam A GA Saitoh Daizoh D Naito Toshio T Abe Toshikazu T

Medicine 20210301 9

<h4>Abstract</h4>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 consumpt ...[more]

PMID: 33655972

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

Abstract

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

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