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Pediatric demographic association with hospital mortality in platelets- and plasma-transfused young pediatric patients — a mixed cohort study

Background Demographic and biochemical variations in newborn children as compared to adults are attributable to variable prognosis to blood transfusions. Aims of this mixed cohort study of Platelets with/without Plasma (PLT/PZ); only Plasma (PZ) transfusions in ≤ 24 months children is as follows: An...

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Published in:The Gazette of the Egyptian Paediatric Association 2024-12, Vol.72 (1), p.64-10, Article 64
Main Authors: Sharma, Sankalp, Padhi, Phalguni
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description Background Demographic and biochemical variations in newborn children as compared to adults are attributable to variable prognosis to blood transfusions. Aims of this mixed cohort study of Platelets with/without Plasma (PLT/PZ); only Plasma (PZ) transfusions in ≤ 24 months children is as follows: An Association of demography towards hospital mortality, and an association of laboratory investigations (LI) with hospital mortality. Methods PLT/PZ ( n  = 72) and PZ ( n  = 79) children ≤ 24 months were followed up for a total length of hospital stay (LOS(D)). We calculated the Odds Ratio (OR) of demographic, and laboratory parameters for mortality, survival studies of demographic, laboratory parameters , Kaplan Meier Survival curve, Log-Rank significance (KMLR) and Multivariable regression ( r 2 ) with outcome as death. Results The present study is in 2019–2022. Higher OR for hospital-based mortality for PLT/PZ and PZ cohort were age ≤ 1 m, weight ≤ 1500 g, preterm, gestational age ≤ 34 weeks, hospital length of stay {LOS(D)} 0–7 days, APGAR score ≤ 5, and Hb ≤ 7 g/dl. High OR, mortality was observed with Female gender, Length of stay before first transfusion {LOS(F)}, 0-7d, WHO Grade of bleeding (GOB) 4, PT >50 sec, INR >1·7, aPTT >75sec, PLT counts (μl) ≤25000/μl (PLT/PZ) and GOB 3, 4 (PZ). Higher OR for mortality was also observed with a lower derangement of coagulative parameters PT ≤50s, INR ≤1·7, aPTT ≤75s (PZ). Higher survival was observed for (PLT/PZ) LOS(F) 0–7 days across age (m), weight (g) ( P  = 0·002; 
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Methods PLT/PZ ( n  = 72) and PZ ( n  = 79) children ≤ 24 months were followed up for a total length of hospital stay (LOS(D)). We calculated the Odds Ratio (OR) of demographic, and laboratory parameters for mortality, survival studies of demographic, laboratory parameters , Kaplan Meier Survival curve, Log-Rank significance (KMLR) and Multivariable regression ( r 2 ) with outcome as death. Results The present study is in 2019–2022. Higher OR for hospital-based mortality for PLT/PZ and PZ cohort were age ≤ 1 m, weight ≤ 1500 g, preterm, gestational age ≤ 34 weeks, hospital length of stay {LOS(D)} 0–7 days, APGAR score ≤ 5, and Hb ≤ 7 g/dl. High OR, mortality was observed with Female gender, Length of stay before first transfusion {LOS(F)}, 0-7d, WHO Grade of bleeding (GOB) 4, PT &gt;50 sec, INR &gt;1·7, aPTT &gt;75sec, PLT counts (μl) ≤25000/μl (PLT/PZ) and GOB 3, 4 (PZ). Higher OR for mortality was also observed with a lower derangement of coagulative parameters PT ≤50s, INR ≤1·7, aPTT ≤75s (PZ). Higher survival was observed for (PLT/PZ) LOS(F) 0–7 days across age (m), weight (g) ( P  = 0·002; &lt; 0·01), and INR  ≤ 1·7; aPTT  ≤ 75 s across LOS(D) ( P  &lt; 0·01,0·018); (PZ) LOS(D) ≤ 7 days across age (m) and weight (g) ( P  = 0·036, 0·001); and GOB across LOS(D) (PLT/PZ; PZ) ( P  = 0·052, 0·005). Demography (PLT/PZ) r 2  = 50·36% ( P  = 0·021), laboratory investigations r 2  = 10·44% ( P  = 0·47), LOS(F) ( P  = 0·010), LOS(D) ( P  = 0·003), and GOB ( P  = 0·03) were the predictors. Demography (PZ) r 2 ( P  = 0·095), investigations r 2  = 8·79% ( P  = 0·254), LOS(D) ( P  = 0·026), and GOB ( P  = 0·012) were the predictors. Conclusions PLT/PZ, demographic parameters, were significant cause of mortality with LOS(F), LOS(D), and GOB as predictors. PZ, demography attributed to mortality with LOS(D), and GOB as predictors. A higher OR of morality with lower derangement of laboratory profile is indicative of unnecessary transfusions in the age group. Laboratory investigations by themselves are not significant predictors of mortality.</description><identifier>ISSN: 2090-9942</identifier><identifier>ISSN: 1110-6638</identifier><identifier>EISSN: 2090-9942</identifier><identifier>DOI: 10.1186/s43054-024-00302-1</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age groups ; Apgar score ; Blood platelets ; Blood transfusion ; Children ; Cohort analysis ; Comparative analysis ; Confidence intervals ; Demographic ; Fresh ; Frozen plasma ; Gestational age ; Health aspects ; Hospital patients ; Hospital stays ; Hospitalization ; Hypotheses ; Laboratories ; Length of stay ; Length of stay before first transfusion ; Medical prognosis ; Medical research ; Medicine ; Medicine &amp; Public Health ; Medicine, Experimental ; Mortality ; Newborn babies ; Patient outcomes ; Patients ; Pediatrics ; Plasma ; Premature babies ; Premature birth ; Prognosis ; Thrombocytopenia ; Variables</subject><ispartof>The Gazette of the Egyptian Paediatric Association, 2024-12, Vol.72 (1), p.64-10, Article 64</ispartof><rights>The Author(s) 2024</rights><rights>COPYRIGHT 2024 Springer</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c377t-e630f196474c7a3353e7e9e1336b751bb3409cfa437c097346cabb6f9c8bb31a3</cites><orcidid>0009-0004-8494-8866 ; 0000-0003-0467-606X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3098557400/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3098557400?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,44590,75126</link.rule.ids></links><search><creatorcontrib>Sharma, Sankalp</creatorcontrib><creatorcontrib>Padhi, Phalguni</creatorcontrib><title>Pediatric demographic association with hospital mortality in platelets- and plasma-transfused young pediatric patients — a mixed cohort study</title><title>The Gazette of the Egyptian Paediatric Association</title><addtitle>Egypt Pediatric Association Gaz</addtitle><description>Background Demographic and biochemical variations in newborn children as compared to adults are attributable to variable prognosis to blood transfusions. Aims of this mixed cohort study of Platelets with/without Plasma (PLT/PZ); only Plasma (PZ) transfusions in ≤ 24 months children is as follows: An Association of demography towards hospital mortality, and an association of laboratory investigations (LI) with hospital mortality. Methods PLT/PZ ( n  = 72) and PZ ( n  = 79) children ≤ 24 months were followed up for a total length of hospital stay (LOS(D)). We calculated the Odds Ratio (OR) of demographic, and laboratory parameters for mortality, survival studies of demographic, laboratory parameters , Kaplan Meier Survival curve, Log-Rank significance (KMLR) and Multivariable regression ( r 2 ) with outcome as death. Results The present study is in 2019–2022. Higher OR for hospital-based mortality for PLT/PZ and PZ cohort were age ≤ 1 m, weight ≤ 1500 g, preterm, gestational age ≤ 34 weeks, hospital length of stay {LOS(D)} 0–7 days, APGAR score ≤ 5, and Hb ≤ 7 g/dl. High OR, mortality was observed with Female gender, Length of stay before first transfusion {LOS(F)}, 0-7d, WHO Grade of bleeding (GOB) 4, PT &gt;50 sec, INR &gt;1·7, aPTT &gt;75sec, PLT counts (μl) ≤25000/μl (PLT/PZ) and GOB 3, 4 (PZ). Higher OR for mortality was also observed with a lower derangement of coagulative parameters PT ≤50s, INR ≤1·7, aPTT ≤75s (PZ). Higher survival was observed for (PLT/PZ) LOS(F) 0–7 days across age (m), weight (g) ( P  = 0·002; &lt; 0·01), and INR  ≤ 1·7; aPTT  ≤ 75 s across LOS(D) ( P  &lt; 0·01,0·018); (PZ) LOS(D) ≤ 7 days across age (m) and weight (g) ( P  = 0·036, 0·001); and GOB across LOS(D) (PLT/PZ; PZ) ( P  = 0·052, 0·005). Demography (PLT/PZ) r 2  = 50·36% ( P  = 0·021), laboratory investigations r 2  = 10·44% ( P  = 0·47), LOS(F) ( P  = 0·010), LOS(D) ( P  = 0·003), and GOB ( P  = 0·03) were the predictors. Demography (PZ) r 2 ( P  = 0·095), investigations r 2  = 8·79% ( P  = 0·254), LOS(D) ( P  = 0·026), and GOB ( P  = 0·012) were the predictors. Conclusions PLT/PZ, demographic parameters, were significant cause of mortality with LOS(F), LOS(D), and GOB as predictors. PZ, demography attributed to mortality with LOS(D), and GOB as predictors. A higher OR of morality with lower derangement of laboratory profile is indicative of unnecessary transfusions in the age group. Laboratory investigations by themselves are not significant predictors of mortality.</description><subject>Age groups</subject><subject>Apgar score</subject><subject>Blood platelets</subject><subject>Blood transfusion</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>Comparative analysis</subject><subject>Confidence intervals</subject><subject>Demographic</subject><subject>Fresh</subject><subject>Frozen plasma</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Hospital patients</subject><subject>Hospital stays</subject><subject>Hospitalization</subject><subject>Hypotheses</subject><subject>Laboratories</subject><subject>Length of stay</subject><subject>Length of stay before first transfusion</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Newborn babies</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Plasma</subject><subject>Premature babies</subject><subject>Premature birth</subject><subject>Prognosis</subject><subject>Thrombocytopenia</subject><subject>Variables</subject><issn>2090-9942</issn><issn>1110-6638</issn><issn>2090-9942</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9Uk2P1SAUbYwmTsb5A65IXHeEQktZTiZ-TDKJLnRNLpT28dJCBV707fwHbvyF_hLvm5qnJsYQci-Xcw4XOFX1nNFrxvruZRactqKmDU7KaVOzR9VFQxWtlRLN4z_yp9VVzntKKZOKt31_UX177wYPJXlLBrfEKcG6wxxyjhbrPgby2Zcd2cW8-gIzWWLC4MuR-EDWGYqbXck1gTCclnmBuiQIeTxkN5BjPISJrOczVpR0oWTy4-t3AmTxXxBk4w5FSS6H4fisejLCnN3Vr3hZfXz96sPt2_r-3Zu725v72nIpS-06TkemOiGFlcB5y510yjHOOyNbZgwXVNkRBJeWKslFZ8GYblS2xz0G_LK623SHCHu9Jr9AOuoIXj8UYpo0pOLt7DQ1klmjGIXWCDoakI1USrXcNMLZfkCtF5vWmuKng8tF7-MhBWxfc6r6tpUC_-WMmgBFfRgjvpNdfLb6pmdUdH0vT6jrf6Bw4O94G4MbPdb_IjQbwaaYc3Lj-TKM6pM99GYPjfbQD_bQDEl8I2UEh8ml3x3_h_UTIxG-3Q</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Sharma, Sankalp</creator><creator>Padhi, Phalguni</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><general>SpringerOpen</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>DOA</scope><orcidid>https://orcid.org/0009-0004-8494-8866</orcidid><orcidid>https://orcid.org/0000-0003-0467-606X</orcidid></search><sort><creationdate>20241201</creationdate><title>Pediatric demographic association with hospital mortality in platelets- and plasma-transfused young pediatric patients — a mixed cohort study</title><author>Sharma, Sankalp ; Padhi, Phalguni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-e630f196474c7a3353e7e9e1336b751bb3409cfa437c097346cabb6f9c8bb31a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age groups</topic><topic>Apgar score</topic><topic>Blood platelets</topic><topic>Blood transfusion</topic><topic>Children</topic><topic>Cohort analysis</topic><topic>Comparative analysis</topic><topic>Confidence intervals</topic><topic>Demographic</topic><topic>Fresh</topic><topic>Frozen plasma</topic><topic>Gestational age</topic><topic>Health aspects</topic><topic>Hospital patients</topic><topic>Hospital stays</topic><topic>Hospitalization</topic><topic>Hypotheses</topic><topic>Laboratories</topic><topic>Length of stay</topic><topic>Length of stay before first transfusion</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Newborn babies</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Plasma</topic><topic>Premature babies</topic><topic>Premature birth</topic><topic>Prognosis</topic><topic>Thrombocytopenia</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sharma, Sankalp</creatorcontrib><creatorcontrib>Padhi, Phalguni</creatorcontrib><collection>SpringerOpen</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest_Health &amp; 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Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>The Gazette of the Egyptian Paediatric Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sharma, Sankalp</au><au>Padhi, Phalguni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric demographic association with hospital mortality in platelets- and plasma-transfused young pediatric patients — a mixed cohort study</atitle><jtitle>The Gazette of the Egyptian Paediatric Association</jtitle><stitle>Egypt Pediatric Association Gaz</stitle><date>2024-12-01</date><risdate>2024</risdate><volume>72</volume><issue>1</issue><spage>64</spage><epage>10</epage><pages>64-10</pages><artnum>64</artnum><issn>2090-9942</issn><issn>1110-6638</issn><eissn>2090-9942</eissn><abstract>Background Demographic and biochemical variations in newborn children as compared to adults are attributable to variable prognosis to blood transfusions. Aims of this mixed cohort study of Platelets with/without Plasma (PLT/PZ); only Plasma (PZ) transfusions in ≤ 24 months children is as follows: An Association of demography towards hospital mortality, and an association of laboratory investigations (LI) with hospital mortality. Methods PLT/PZ ( n  = 72) and PZ ( n  = 79) children ≤ 24 months were followed up for a total length of hospital stay (LOS(D)). We calculated the Odds Ratio (OR) of demographic, and laboratory parameters for mortality, survival studies of demographic, laboratory parameters , Kaplan Meier Survival curve, Log-Rank significance (KMLR) and Multivariable regression ( r 2 ) with outcome as death. Results The present study is in 2019–2022. Higher OR for hospital-based mortality for PLT/PZ and PZ cohort were age ≤ 1 m, weight ≤ 1500 g, preterm, gestational age ≤ 34 weeks, hospital length of stay {LOS(D)} 0–7 days, APGAR score ≤ 5, and Hb ≤ 7 g/dl. High OR, mortality was observed with Female gender, Length of stay before first transfusion {LOS(F)}, 0-7d, WHO Grade of bleeding (GOB) 4, PT &gt;50 sec, INR &gt;1·7, aPTT &gt;75sec, PLT counts (μl) ≤25000/μl (PLT/PZ) and GOB 3, 4 (PZ). Higher OR for mortality was also observed with a lower derangement of coagulative parameters PT ≤50s, INR ≤1·7, aPTT ≤75s (PZ). Higher survival was observed for (PLT/PZ) LOS(F) 0–7 days across age (m), weight (g) ( P  = 0·002; &lt; 0·01), and INR  ≤ 1·7; aPTT  ≤ 75 s across LOS(D) ( P  &lt; 0·01,0·018); (PZ) LOS(D) ≤ 7 days across age (m) and weight (g) ( P  = 0·036, 0·001); and GOB across LOS(D) (PLT/PZ; PZ) ( P  = 0·052, 0·005). Demography (PLT/PZ) r 2  = 50·36% ( P  = 0·021), laboratory investigations r 2  = 10·44% ( P  = 0·47), LOS(F) ( P  = 0·010), LOS(D) ( P  = 0·003), and GOB ( P  = 0·03) were the predictors. Demography (PZ) r 2 ( P  = 0·095), investigations r 2  = 8·79% ( P  = 0·254), LOS(D) ( P  = 0·026), and GOB ( P  = 0·012) were the predictors. Conclusions PLT/PZ, demographic parameters, were significant cause of mortality with LOS(F), LOS(D), and GOB as predictors. PZ, demography attributed to mortality with LOS(D), and GOB as predictors. A higher OR of morality with lower derangement of laboratory profile is indicative of unnecessary transfusions in the age group. Laboratory investigations by themselves are not significant predictors of mortality.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1186/s43054-024-00302-1</doi><tpages>10</tpages><orcidid>https://orcid.org/0009-0004-8494-8866</orcidid><orcidid>https://orcid.org/0000-0003-0467-606X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Age groups
Apgar score
Blood platelets
Blood transfusion
Children
Cohort analysis
Comparative analysis
Confidence intervals
Demographic
Fresh
Frozen plasma
Gestational age
Health aspects
Hospital patients
Hospital stays
Hospitalization
Hypotheses
Laboratories
Length of stay
Length of stay before first transfusion
Medical prognosis
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Mortality
Newborn babies
Patient outcomes
Patients
Pediatrics
Plasma
Premature babies
Premature birth
Prognosis
Thrombocytopenia
Variables
title Pediatric demographic association with hospital mortality in platelets- and plasma-transfused young pediatric patients — a mixed cohort study
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