Changes in Transfusion Practice in Children and Adolescents over Time

Abstract

Introduction: In recent years, resource-saving handling of allogeneic blood products and a reduction of transfusion rates in adults has been observed. However, comparable published national data for transfusion practices in pediatric patients are currently not available. In this study, the transfusion rates for children and adolescents were analyzed based on data from the Federal Statistical Office of Germany during the past 2 decades. Methods: Data were queried via the database of the Federal Statistical Office (Destasis). The period covered was from 2005 to 2018, and those in the sample group were children and adolescents aged 0-17 years receiving inpatient care. Operation and procedure codes (OPS) for transfusions, procedures, or interventions with increased transfusion risk were queried and evaluated in detail. Results: In Germany, 0.9% of the children and adolescents treated in hospital received a transfusion in 2018. A reduction in transfusion rates from 1.02% (2005) to 0.9% (2018) was observed for the total collective of children and adolescents receiving inpatient care. Increases in transfusion rates were recorded for 1-to 4-(1.41-1.45%) and 5-to 10-year-olds (1.24-1.33%). Children under 1 year of age were most frequently transfused (in 2018, 40.2% of the children were cared for in hospital). Transfusion-associated procedures such as chemotherapy or machine ventilation and respiratory support for new-borns and infants are on the rise. Conclusion: Transfusion rates are declining in children and adolescents, but the reasons for increases in transfusion rates in other groups are unclear. Prospective studies to evaluate transfusion rates and triggers in children are urgently needed.

Independent Risk Factors for RBC Transfusion in Children Undergoing Surgery. Analysis of 14,248 Cases at a German University Hospital

“…In the German coding and billing system 'Diagnosis-Related Groups (DRGs)', surgeries and procedures are coded with a surgical or interventional procedural code (OPS), and diagnoses are coded with an international classification of disease (ICD) code, as reported previously [8,9]. Demographic (age and gender) and additional routine data (admission and discharge dates, discharge type, Hb value at admission and discharge, OPS and ICD codes, RBC, platelet, fresh frozen plasma (FFP), fibrinogen, and prothrombin complex concentrate (PCC) total consumption) from the hospital information system (ORBIS ® , Agfa HealthCare, Bonn, Germany) were extracted, with help from the IT department, and consecutively validated by the statistician in charge.…”

“…Blood sparing techniques have always been the focus for paediatricians; however, studies dealing with this topic are rare. Although decreased transfusion rates for children in general and for those severely injured have been demonstrated, results for children undergoing surgery are scarce [9,10]. Currently, there are only a small number of studies in paediatric surgery that investigated transfusion strategies, such as from paediatric cardiac surgical patients [11].…”