title: Blood transfusions in children: a multi-institutional analysis of practices and complications.
abstract: BACKGROUND
  Blood product transfusions are a valuable health-care resource. Guidelines for transfusion exist, but variability in their application, particularly in children, remains. The risk factors that threaten transfusion safety are well established, but because their occurrence in children is rare, single-institution studies have limited utility in determining the rates of occurrence. An epidemiologic approach that investigates blood transfusions in hospitalized children may help improve our understanding of transfused blood products in this vulnerable population.
  
  
  METHODS
  This was a nonconcurrent cohort study of pediatric patients not more than 18 years of age hospitalized from 2001 to 2003 at 35 academic children's hospitals that are members of the Pediatric Health Information System (PHIS).
  
  
  RESULTS
  A total of 51,720 (4.8%) pediatric patients received blood product transfusions during the study period. Red blood cells (n = 44,632) and platelets (n = 14,274) were the two most frequently transfused products. The rate of transfusions was highest among children with neutropenia, agranulocytosis, and sickle cell crisis. Asian and American Indian patients had important differences in the rate of blood transfusions and their complications. Resource use in terms of length of stay and costs were higher in patients who received transfusion. Of those patients who received transfusions, 492 (0.95%) experienced a complication from the administered blood product. This accounted for a rate of complications of 10.7 per 1,000 units transfused.
  
  
  CONCLUSIONS
  The administration of blood products to children is a common practice in academic children's hospitals. Complications associated with these transfused products are rare.
authors: Children's National Medical Center and the George Washington University School of Medicine, Washington, DC 20010, USA. aslonim@cnmc.org
authors: Anthony D
authors: AD
authors: Slonim
authors: Jill G
authors: JG
authors: Joseph
authors: Wendy M
authors: WM
authors: Turenne
authors: Aditi
authors: A
authors: Sharangpani
authors: Naomi L C
authors: NL
authors: Luban
mesh_terms: D000380:Agranulocytosis / Q000150:complications / Q000628:therapy; D000755:Anemia, Sickle Cell / Q000150:complications / Q000628:therapy; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D004812:Epidemiologic Methods; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D009503:Neutropenia / Q000150:complications / Q000628:therapy; D017713:Platelet Transfusion; D065227:Transfusion Reaction