Trends in blood transfusion among hospitalized children with sickle cell disease

Jean L. Raphael, Suzette Olu Busola Oyeku, Marc A. Kowalkowski, Brigitta U. Mueller, Angela M. Ellison

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Blood transfusions represent a major therapeutic option in acute management of sickle cell disease (SCD). Few data exist documenting trends in transfusion among children with SCD, particularly during hospitalization. Procedure: This was an analysis of cross-sectional data of hospital discharges within the Kid's Inpatient Database (years 1997, 2000, 2003, 2006, 2009). Hospitalizations for children (0-18 years) with a primary or secondary SCD-related diagnosis were examined. The primary outcome was blood transfusion. Trends in transfusion were assessed using weighted multivariate logistic regression in a merged dataset with year as the primary independent variable. Co-variables consisted of child and hospital characteristics. Multivariate logistic regression was conducted for 2009 data to assess child and hospital-level factors associated with transfusion. Results: From 1997 to 2009, the percentage of SCD-related hospitalizations with transfusion increased from 14.2% to 28.8% (P<0.0001). Among all SCD-related hospitalizations, the odds of transfusion increased over 20% for each successive study interval. Hospitalizations with vaso-occlusive pain crisis (OR 1.35, 95% CI 1.27-1.43) or acute chest syndrome/pneumonia (OR 1.24, 95% CI 1.13-1.35) as the primary diagnoses had the highest odds of transfusion for each consecutive study interval. Older age and male gender were associated with higher odds of transfusion. Conclusions: Blood transfusion is increasing over time among hospitalized children with SCD. Further study is warranted to identify indications contributing to the rise in transfusions and if transfusions in the inpatient setting have been used appropriately. Future studies should also assess the impact of rising trends on morbidity, mortality, and other health-related outcomes. Pediatr Blood Cancer 2013;60:1753-1758.

Original languageEnglish (US)
Pages (from-to)1753-1758
Number of pages6
JournalPediatric Blood and Cancer
Volume60
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Hospitalized Child
Sickle Cell Anemia
Blood Transfusion
Hospitalization
Inpatients
Acute Chest Syndrome
Logistic Models
Pneumonia
Cross-Sectional Studies
Databases
Morbidity
Pain
Mortality
Health
Neoplasms

Keywords

  • Epidemiology
  • Health care utilization
  • Outcomes research
  • Sickle cell disease

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Trends in blood transfusion among hospitalized children with sickle cell disease. / Raphael, Jean L.; Oyeku, Suzette Olu Busola; Kowalkowski, Marc A.; Mueller, Brigitta U.; Ellison, Angela M.

In: Pediatric Blood and Cancer, Vol. 60, No. 11, 11.2013, p. 1753-1758.

Research output: Contribution to journalArticle

Raphael, Jean L. ; Oyeku, Suzette Olu Busola ; Kowalkowski, Marc A. ; Mueller, Brigitta U. ; Ellison, Angela M. / Trends in blood transfusion among hospitalized children with sickle cell disease. In: Pediatric Blood and Cancer. 2013 ; Vol. 60, No. 11. pp. 1753-1758.
@article{1814d5b9e7b9454b96b77e3ee8501f00,
title = "Trends in blood transfusion among hospitalized children with sickle cell disease",
abstract = "Background: Blood transfusions represent a major therapeutic option in acute management of sickle cell disease (SCD). Few data exist documenting trends in transfusion among children with SCD, particularly during hospitalization. Procedure: This was an analysis of cross-sectional data of hospital discharges within the Kid's Inpatient Database (years 1997, 2000, 2003, 2006, 2009). Hospitalizations for children (0-18 years) with a primary or secondary SCD-related diagnosis were examined. The primary outcome was blood transfusion. Trends in transfusion were assessed using weighted multivariate logistic regression in a merged dataset with year as the primary independent variable. Co-variables consisted of child and hospital characteristics. Multivariate logistic regression was conducted for 2009 data to assess child and hospital-level factors associated with transfusion. Results: From 1997 to 2009, the percentage of SCD-related hospitalizations with transfusion increased from 14.2{\%} to 28.8{\%} (P<0.0001). Among all SCD-related hospitalizations, the odds of transfusion increased over 20{\%} for each successive study interval. Hospitalizations with vaso-occlusive pain crisis (OR 1.35, 95{\%} CI 1.27-1.43) or acute chest syndrome/pneumonia (OR 1.24, 95{\%} CI 1.13-1.35) as the primary diagnoses had the highest odds of transfusion for each consecutive study interval. Older age and male gender were associated with higher odds of transfusion. Conclusions: Blood transfusion is increasing over time among hospitalized children with SCD. Further study is warranted to identify indications contributing to the rise in transfusions and if transfusions in the inpatient setting have been used appropriately. Future studies should also assess the impact of rising trends on morbidity, mortality, and other health-related outcomes. Pediatr Blood Cancer 2013;60:1753-1758.",
keywords = "Epidemiology, Health care utilization, Outcomes research, Sickle cell disease",
author = "Raphael, {Jean L.} and Oyeku, {Suzette Olu Busola} and Kowalkowski, {Marc A.} and Mueller, {Brigitta U.} and Ellison, {Angela M.}",
year = "2013",
month = "11",
doi = "10.1002/pbc.24630",
language = "English (US)",
volume = "60",
pages = "1753--1758",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "11",

}

TY - JOUR

T1 - Trends in blood transfusion among hospitalized children with sickle cell disease

AU - Raphael, Jean L.

AU - Oyeku, Suzette Olu Busola

AU - Kowalkowski, Marc A.

AU - Mueller, Brigitta U.

AU - Ellison, Angela M.

PY - 2013/11

Y1 - 2013/11

N2 - Background: Blood transfusions represent a major therapeutic option in acute management of sickle cell disease (SCD). Few data exist documenting trends in transfusion among children with SCD, particularly during hospitalization. Procedure: This was an analysis of cross-sectional data of hospital discharges within the Kid's Inpatient Database (years 1997, 2000, 2003, 2006, 2009). Hospitalizations for children (0-18 years) with a primary or secondary SCD-related diagnosis were examined. The primary outcome was blood transfusion. Trends in transfusion were assessed using weighted multivariate logistic regression in a merged dataset with year as the primary independent variable. Co-variables consisted of child and hospital characteristics. Multivariate logistic regression was conducted for 2009 data to assess child and hospital-level factors associated with transfusion. Results: From 1997 to 2009, the percentage of SCD-related hospitalizations with transfusion increased from 14.2% to 28.8% (P<0.0001). Among all SCD-related hospitalizations, the odds of transfusion increased over 20% for each successive study interval. Hospitalizations with vaso-occlusive pain crisis (OR 1.35, 95% CI 1.27-1.43) or acute chest syndrome/pneumonia (OR 1.24, 95% CI 1.13-1.35) as the primary diagnoses had the highest odds of transfusion for each consecutive study interval. Older age and male gender were associated with higher odds of transfusion. Conclusions: Blood transfusion is increasing over time among hospitalized children with SCD. Further study is warranted to identify indications contributing to the rise in transfusions and if transfusions in the inpatient setting have been used appropriately. Future studies should also assess the impact of rising trends on morbidity, mortality, and other health-related outcomes. Pediatr Blood Cancer 2013;60:1753-1758.

AB - Background: Blood transfusions represent a major therapeutic option in acute management of sickle cell disease (SCD). Few data exist documenting trends in transfusion among children with SCD, particularly during hospitalization. Procedure: This was an analysis of cross-sectional data of hospital discharges within the Kid's Inpatient Database (years 1997, 2000, 2003, 2006, 2009). Hospitalizations for children (0-18 years) with a primary or secondary SCD-related diagnosis were examined. The primary outcome was blood transfusion. Trends in transfusion were assessed using weighted multivariate logistic regression in a merged dataset with year as the primary independent variable. Co-variables consisted of child and hospital characteristics. Multivariate logistic regression was conducted for 2009 data to assess child and hospital-level factors associated with transfusion. Results: From 1997 to 2009, the percentage of SCD-related hospitalizations with transfusion increased from 14.2% to 28.8% (P<0.0001). Among all SCD-related hospitalizations, the odds of transfusion increased over 20% for each successive study interval. Hospitalizations with vaso-occlusive pain crisis (OR 1.35, 95% CI 1.27-1.43) or acute chest syndrome/pneumonia (OR 1.24, 95% CI 1.13-1.35) as the primary diagnoses had the highest odds of transfusion for each consecutive study interval. Older age and male gender were associated with higher odds of transfusion. Conclusions: Blood transfusion is increasing over time among hospitalized children with SCD. Further study is warranted to identify indications contributing to the rise in transfusions and if transfusions in the inpatient setting have been used appropriately. Future studies should also assess the impact of rising trends on morbidity, mortality, and other health-related outcomes. Pediatr Blood Cancer 2013;60:1753-1758.

KW - Epidemiology

KW - Health care utilization

KW - Outcomes research

KW - Sickle cell disease

UR - http://www.scopus.com/inward/record.url?scp=84883778809&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883778809&partnerID=8YFLogxK

U2 - 10.1002/pbc.24630

DO - 10.1002/pbc.24630

M3 - Article

C2 - 23775719

AN - SCOPUS:84883778809

VL - 60

SP - 1753

EP - 1758

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 11

ER -