No Difference in the Incidence of Complications in Pediatric Patients with Moderate Anemia 30 Days after Pediatric Hip Surgery with and without Blood Transfusion.

Phasuth Chutarattanakul,Piyanuch Musikachart,Jidapa Wongcharoenwatana,Kamolporn Kaewpornsawan,Perajit Eamsobhana

doi:10.3390/children9020161

Phasuth Chutarattanakul, Piyanuch Musikachart + Show 3 more

Open Access

https://doi.org/10.3390/children9020161

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Journal: Children	Publication Date: Jan 27, 2022
Citations: 1	License type: CC BY 4.0

Affiliation: Siriraj Hospital, Mahidol University

Abstract

This study investigated the association between postoperative blood transfusion and the incidence of postoperative complications 30 days after pediatric hip surgery as well as factors significantly associated with 30-day postoperative complications. Patients were divided into two groups: those with postoperative complications and those with no complications. Postoperative hematocrit (Hct) was categorized as <25%, 25–30%, and >30%. Comparison was made between all postoperative complications at the 30-day follow-up that were influenced by anemia in patients who received transfusion and those who did not. A multivariate logistic regression model was used to identify factors independently associated with postoperative complications. The overall 30-day postoperative complication rate for all patients was 17% (24/138). No significant difference between the transfusion and the non-transfusion patients was found. Preoperative hematocrit (Hct) was significantly lower in the complications group (p = 0.030), and both length of stay and 30-day readmission were significantly higher in patients with complications (p = 0.011 and p < 0.001, respectively). Multivariate analysis revealed female gender (OR: 3.50, 95% CI: 1.18–10.36; p = 0.026) and length of hospital stay (OR: 1.23, 95% CI: 1.08–1.41; p = 0.004) to be factors independently associated with 30-day postoperative complications. However, no statistically significant difference in the incidence of complications at 30 days following pediatric hip dysplasia surgery was found between patients who received blood transfusion to maintain a Hct level ≥25% and those not receiving transfusion.

Highlights

Pelvic surgery of pediatric hip dysplasia patients, both with and without proximal femoral osteotomy, is a challenging surgical treatment
When we evaluated the 30-day postoperative complication incidence for postoperative Hct levels 30% in the transfusion and non-transfusion groups, we found no significant difference between the groups for any type of complication, including superficial/deep infection, urinary tract infection, pneumonia, prolonged fever, upper respiratory tract infection, asthmatic attack, deep vein thrombosis, acute allergic reaction from blood transfusion, and large hematoma at the surgical site (Table 4)
The incidence in the present study is slightly higher because we included upper respiratory tract infections (URI) as URI has shown a correlation with anemia [19]

Summary

Introduction

Pelvic surgery of pediatric hip dysplasia patients, both with and without proximal femoral osteotomy, is a challenging surgical treatment. The incidence of hip dysplasia in the general population is 1 to 25 per 1000 live births [1,2,3]. Treatment of hip dysplasia in children older than 18 months usually requires open reduction, either with or without osteotomy of the innominate bone and the proximal femur [4]. Pediatric hip surgery, which includes femoral and/or acetabular osteotomy, often results in significant blood loss and postoperative anemia [5]. Transfusion is recommended in patients with general pediatric illnesses and hematocrit (Hct) levels

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