Department of Pediatrics, Division of Hematology/Oncology, Saint Louis University, Cardinal Glennon Children's Medical Center, St Louis, MO 63104, USA.
J Pediatr. 2012 Feb;160(2):210-215.e1. doi: 10.1016/j.jpeds.2011.08.013. Epub 2011 Sep 14.
To determine the pattern, prevalence and potential complications of fresh frozen plasma (FFP) use in US pediatric hospitals from 2002-2009.
Retrospective cohort study using the Pediatric Health Information System (PHIS) administrative database, which was queried for FFP admissions using diagnostic, procedural, and billing codes. Demographic data, daily use, and procedural codes were used to describe the patient population and pattern of FFP use.
Of 3 252 149 PHIS-recorded admissions, 2.85% had codes consistent with FFP use. This percentage did not change over the course of the study (P=.10). FFP was most commonly administered to children <1 year of age (54%), critically ill children (70%), and those with heart disease (34%). Fifteen percent of FFP-related admissions involved a thrombotic event. The overall mortality rate was 17% and it decreased during the study (P<.001). There was noteworthy variation in the proportion of FFP admissions among participating institutions.
FFP is commonly used in children admitted to PHIS hospitals. Despite recent expert recommendations highlighting the lack of efficacy in many clinical scenarios, the rate of FFP use does not appear to be changing. Randomized, controlled studies are needed to determine appropriate indications for FFP use and evaluate for potential complications.
确定 2002-2009 年美国儿科医院新鲜冷冻血浆（FFP）使用的模式、流行率和潜在并发症。
使用儿科健康信息系统（PHIS）行政数据库进行回顾性队列研究，该数据库使用诊断、程序和计费代码查询 FFP 入院情况。人口统计学数据、每日使用和程序代码用于描述患者人群和 FFP 使用模式。
在 3252149 份 PHIS 记录的入院记录中，有 2.85%的记录有与 FFP 使用相符的代码。在研究过程中，这一比例没有变化（P=.10）。FFP 最常用于<1 岁的儿童（54%）、危重病儿童（70%）和心脏病儿童（34%）。15%的 FFP 相关入院涉及血栓事件。总体死亡率为 17%，且在研究期间有所下降（P<.001）。参与机构之间的 FFP 入院比例存在显著差异。
FFP 常用于 PHIS 医院收治的儿童。尽管最近的专家建议强调了在许多临床情况下缺乏疗效，但 FFP 的使用率似乎没有变化。需要进行随机对照研究，以确定 FFP 使用的适当适应证，并评估潜在的并发症。
