title: The Effect of Hemoglobin Levels on Mortality in Pediatric Patients with Severe Traumatic Brain Injury.
abstract: Objective. There is increasing evidence of adverse outcomes associated with blood transfusions for adult traumatic brain injury patients. However, current evidence suggests that pediatric traumatic brain injury patients may respond to blood transfusions differently on a vascular level. This study examined the influence of blood transfusions and anemia on the outcome of pediatric traumatic brain injury patients. Design. A retrospective cohort analysis of severe pediatric traumatic brain injury (TBI) patients was undertaken to investigate the association between blood transfusions and anemia on patient outcomes. Measurements and Main Results. One hundred and twenty patients with severe traumatic brain injury were identified and included in the analysis. The median Glasgow Coma Scale (GCS) was 6 and the mean hemoglobin (Hgb) on admission was 115.8 g/L. Forty-three percent of patients (43%) received at least one blood transfusion and the mean hemoglobin before transfusion was 80.1 g/L. Multivariable regression analysis revealed that anemia and the administration of packed red blood cells were not associated with adverse outcomes. Factors that were significantly associated with mortality were presence of abusive head trauma, increasing PRISM score, and low GCS after admission. Conclusion. In this single centre retrospective cohort study, there was no association found between anemia, blood transfusions, and hospital mortality in a pediatric traumatic brain injury patient population.
authors.affiliation: Department of Anesthesia, Foothills Medical Centre, University of Calgary, 1403 29 Street NW, Calgary, AB, Canada T2N 2T9.
authors.forename: Kevin F
authors.identifier: 0000-0003-3540-0699
authors.initials: KF
authors.lastname: Yee
authors.affiliation: Department of Anesthesia, Foothills Medical Centre, University of Calgary, 1403 29 Street NW, Calgary, AB, Canada T2N 2T9.
authors.forename: Andrew M
authors.identifier: 0000-0001-6012-0045
authors.initials: AM
authors.lastname: Walker
authors.affiliation: Section of Critical Care, Department of Pediatrics, Faculty of Medicine, University of Calgary, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8.
authors.forename: Elaine
authors.identifier: 0000-0002-2939-8716
authors.initials: E
authors.lastname: Gilfoyle
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D001803:Blood Transfusion; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000378:metabolism / Q000401:mortality*; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D017707:Erythrocyte Transfusion; D005260:Female; D015600:Glasgow Coma Scale; D006454:Hemoglobins / Q000378:metabolism*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins