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Journal of Current Pediatric Research | Volume: 23
March 14-15, 2019 | London, UK
International Conference on
Pediatrics & Neonatal Healthcare
Claudine Kumba
Lenoire A, Cairet P, Dogaru-Dedieu E, Belloni I
and
Orliaguet G
Necker Sick Children’s University Hospital, France
Is transfusion an independent predictive risk factor of postoperative outcome in
Pediatric Orthopedic surgical patients? A retrospective study
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.
Objectives:
To investigate whether transfusion was an
independent risk factor of postoperative outcome in pediatric
orthopedic surgical patients.
Design:
Retrospective observational descriptive pediatric
cohort study.
Setting:
Monocentric pediatric tertiary center, Necker University
Sick Children’s Hospital Paris, from 1 January 2014 to 17 Mai
2017.
Patients:
195 patients with a median age of 144months [106.5-
178.5] were included. Inclusion criteria was the presence or the
absenceof transfusion in the Intraoperativeperiod inorthopedic
surgery. Exclusion criterion was transfusion in the postoperative
period until discharge from hospital. Main outcome measures:
Primary outcome was morbidity in transfused and non-
transfused patients. Morbidity was assessed by deaths,
complications and repeat surgery occurring intraoperatively
or postoperatively during the entire hospitalization. Secondary
outcome was assessed by length of stay in the intensive care
unit, in the hospitalization ward, total length of stay in hospital
and duration of mechanical ventilation.
Statistical analysis:
Multiple logistic and log-linear regressions
were used to assess for independent predictors of outcome.
Results:
ASA score [odds ratio 2.73, p-value <0.01] and
transfusion [odds ratio 1.98, p-value <0.01] were independent
predictive risk factors for complications. Emergency surgery
[odds ratio 7.62, p-value<0.01] was the independent predictive
risk factor for repeat surgery. ASA score, transfusion and
emergency surgery [p-value<0.01] were independent
predictive risk factors for length of stay in the intensive care
unit and length of stay in hospital. ASA score, transfusion and
age [p-value<0.01] were independent predictive risk factors
for length of mechanical ventilation. There was no mortality
in this cohort.
Conclusions:
Transfusion was an independent predictive risk
factor among others for postoperative outcome. Specific
measures aiming to reduce exposure to blood products in
potential hemorrhagic surgery like scoliosis can improve
outcome.
Speaker Biography
ClaudineKumbagraduatedasaMedicalDoctor in2001andcompletedherspecialization
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
specialization graduation since 2014 from the University of Montpellier 1, Montpellier,
France. She is a paediatric anaesthesiologist in Necker Sick Children’s 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).
e:
claudine.kumba@gmail.comNotes:
Claudine Kumba et al.
, Curr Pediatr Res, Volume 23
DOI: 10.4066/0971-9032-C1-010