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Journal of Public Health Policy and Planning | Volume 3
April 08-09, 2019 | Zurich, Switzerland
Health Care and Neuroscience
International Conference on
Transfusion and morbi-mortality factors: An observaƟonal descripƟve retrospecƟve
pediatric cohort study
Claudine Kumba, Fabiola Cresci, Camille Picard, Cécile Thiry, Souha Albinni and Gilles Orliaguet
Necker Enfants Malades University Hospital, France
Background: Intraoperative and postoperative
morbi-mortality factors are multiple in pediatric
patients. Studies in pediatric cardiac surgery and
intensive care patients have identified transfusion
as one independent factor among others. There
is not a lot of data concerning transfusion related
morbi-mortality in other pediatric patients fields
like neurosurgery, abdominal and orthopedic
surgery. These were investigated.
Objectives: To identify morbi-mortality risk factors
in intraoperatively transfused and not transfused
pediatric patients in neurosurgery, abdominal and
orthopedic surgery.
Design: Retrospective observational descriptive
pediatric cohortstudy.
Setting: Monocentric pediatric tertiary center, Necker
Enfants Malades University Hospital Paris, from 1
January 2014 to 17 May 2017.
Patients: 594 patients with mean age of 90.86
±71.80 months were included. Inclusion criteria were
the presence or the absence of transfusion in the
intraoperative period in neurosurgery, abdominal
and orthopedic surgery patients. Exclusion criterion
was transfusion in the postoperative period until
discharge from hospital.
Main outcome measures: Primary outcome was
mortality and secondary outcome was morbidity in
transfused and non transfused patients. Mortality
was assessed by deaths occuring intraoperatively
or postoperatively during the entire hospitalisation.
Morbidity was assessed by intraoperative,
postoperative complications, repeat surgery, length
of stay in the intensive care unit, in the hospitalisation
ward, total length of stay in hospital and length of
mechanical ventilation.
Results: Multivariate analysis revealed that ASA
score was the independent risk factor for mortality
(odds ratio 28.78, p-value<0.001). Transfusion
(p-value<0.01), emergency surgery (p-value<0.05),
type of surgery (<0.01), age (<0.05) and prematurity
(<0.001) were independent risk factors for morbidity.
Conclusions: Patient outcome can be improved by
applying specific preventive measures on each risk
factor.
Speaker Biography
Claudine Kumba graduated as a Medical Doctor in 2001 and completed her
specialisation in Anesthesiology in 2006 at the Free University of Brussels
(ULB, Université Libre de Bruxelles). She has a Paediatric Anaesthesia
specialisation graduation since 2010 from the University of Aix- Marseille,
Marseille, France. She has a Critical Care Medicine specialisation graduation
since 2014 from the University of Montpellier, Montpellier, France. She
is a paediatric anaesthesiologist in Necker Enfants Malades University
Hospital, in Paris, France. She has 12 publications and 17 citations. She is
a member of the European Society of Paediatric Anaesthesiology (ESPA),
the French Society of Anaesthesia and Critical Care (SFAR, Société Française
d’Anesthésie-Réanimation) and the French Association for Paediatric
Anaesthesiolgists and Intensivists) (ADARPEF, Association d’Anesthésistes
et Réanimateurs Pédiatriques d’Expression Française) and the Belgian
Association for Paediatric Anaesthesiology (BAPA).
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