title: Widespread use of fresh frozen plasma in US children's hospitals despite limited evidence demonstrating a beneficial effect.
abstract: OBJECTIVE
  To determine the pattern, prevalence and potential complications of fresh frozen plasma (FFP) use in US pediatric hospitals from 2002-2009.
  
  
  METHODS
  Retrospective cohort study using the Pediatric Health Information System (PHIS) administrative database, which was queried for FFP admissions using diagnostic, procedural, and billing codes. Demographic data, daily use, and procedural codes were used to describe the patient population and pattern of FFP use.
  
  
  RESULTS
  Of 3 252 149 PHIS-recorded admissions, 2.85% had codes consistent with FFP use. This percentage did not change over the course of the study (P=.10). FFP was most commonly administered to children <1 year of age (54%), critically ill children (70%), and those with heart disease (34%). Fifteen percent of FFP-related admissions involved a thrombotic event. The overall mortality rate was 17% and it decreased during the study (P<.001). There was noteworthy variation in the proportion of FFP admissions among participating institutions.
  
  
  CONCLUSIONS
  FFP is commonly used in children admitted to PHIS hospitals. Despite recent expert recommendations highlighting the lack of efficacy in many clinical scenarios, the rate of FFP use does not appear to be changing. Randomized, controlled studies are needed to determine appropriate indications for FFP use and evaluate for potential complications.
authors.affiliation: Department of Pediatrics, Division of Hematology/Oncology, Saint Louis University, Cardinal Glennon Children's Medical Center, St Louis, MO 63104, USA. puetzjj@slu.edu
authors.forename: John
authors.initials: J
authors.lastname: Puetz
authors.forename: Char
authors.initials: C
authors.lastname: Witmer
authors.forename: Yuan-Shung V
authors.initials: YS
authors.lastname: Huang
authors.forename: Leslie
authors.initials: L
authors.lastname: Raffini
mesh_terms: D000293:Adolescent; D016913:Blood Component Transfusion / Q000009:adverse effects* / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D010949:Plasma; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014481:United States