574 - Epidemiology of Platelet Transfusions in Hospitalized Children: A PHIS Database Study

Poster Number: 574
Publication Number: 574.321

Emily A. Lang, Weill Cornell Medicine, New York, NY, United States; Anjile An, Weill Cornell Medicine, New York, NY, United States; Sarah J. Finn, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Fisnik Prishtina, NewYork-Presbyterian Morgan Stanley Children's Hospital, NY, NY, United States; Robert A. DeSimone, Weill Cornell Medicine, New York, NY, United States; Marianne E. Nellis, Weill Cornell Medicine, New York, NY, United States

Background: Platelet transfusions are frequently prescribed to children. However, they are associated with significant morbidity and mortality. While multiple studies have characterized the prevalence of platelet transfusions in particular subsets of pediatric patients, few studies have described the epidemiology and complications of pediatric platelet transfusions across a wide variety of hospital settings or periods of time.

Objective: To describe the epidemiology and complications of platelet transfusions among hospitalized pediatric patients during 2010-2019.

Design/Methods: We performed a retrospective cohort study of hospitalized children within the Pediatric Health Information System (PHIS) database. Pediatric encounters (age 0-18 years) receiving at least one platelet transfusion during hospitalization from 2010-2019 were identified. Data regarding patient demographics, admitting diagnosis, complex chronic conditions, procedures required during hospitalization, complications, and outcomes were extracted for eligible encounters.

Results: Within the PHIS database, 6,284,264 hospitalizations occurred from 2010-2019. 244,464 hospitalizations required at least one platelet transfusion, yielding a prevalence of 3.89% (95% CI: 3.87-3.91%). Transfusion prevalence did not change significantly across the decade (p-value = 0.152, range = 3.69-4.28%). Two-thirds of children receiving platelet transfusions were in their first six years of life, and the majority identified as male (55%) and white (61%). Recipients most commonly had diseases of the circulatory system (21%, 52,008/244,979), perinatal disorders (16%, 38,054/244,979), or diseases of the hematologic and/or immune systems (15%, 37,466/244,979), and 91% had complex chronic conditions. Many required mechanical ventilation (44%), underwent a procedure in the operating room (53%), or were supported by extracorporeal membrane oxygenation (ECMO) (5%). When adjusted for age, need for support by ECMO, mechanical ventilation, and surgical intervention, the odds of thrombosis, infection, and mortality increased by 2% (OR 1.02, 95% CI: 1.016-1.020), 3% (OR 1.03, 95% CI: 1.027-1.033), and 7% (OR 1.07, 95% CI: 1.067-1.071) respectively with each additional transfusion.Conclusion(s): The prevalence of platelet transfusions among pediatric inpatients remained consistent over the past decade. Increasing numbers of platelet transfusions are associated with increased morbidity and mortality, highlighting the need to develop more stringent transfusion guidelines in pediatric patients.
Emily A. Lang's CVEmily Lang CV_Dec_2021.pdf