Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHC, Liège, Belgium.
Université de Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France.
Pediatr Crit Care Med. 2019 Sep;20(9):e400-e409. doi: 10.1097/PCC.0000000000002015.
To determine the prevalence and risk markers of anemia at PICU discharge.
Bicenter retrospective cohort study.
Two multidisciplinary French PICUs.
All children admitted during a 5-year period, staying in the PICU for at least 2 days, and for whom a hemoglobin was available at PICU discharge.
None.
Patient, admission, and PICU stay characteristics were retrospectively collected in the electronic medical records of each participating PICU. Anemia was defined according to the World Health Organization criteria. Among the 3,170 patients included for analysis, 1,868 (58.9%) were anemic at discharge from PICU. The proportion of anemic children differed between age categories, whereas the median hemoglobin level did not exhibit significant variations according to age. After multivariate adjustment, anemia at PICU admission was the strongest predictor of anemia at PICU discharge, and the strength of this association varied according to age (interaction). Children anemic at PICU admission had a reduced risk of anemia at PICU discharge if transfused with RBCs during the PICU stay, if less than 6 months old, or if creatinine level at PICU admission was low. Children not anemic at PICU admission had an increased risk of anemia at PICU discharge if they were thrombocytopenic at PICU admission, if they had higher C-reactive protein levels, and if they received plasma transfusion, inotropic/vasopressor support, or mechanical ventilation during the PICU stay.
Anemia is frequent after pediatric critical illness. Anemia status at PICU admission defines different subgroups of critically ill children with specific prevalence and risk markers of anemia at PICU discharge. Further studies are required to confirm our results, to better define anemia during pediatric critical illness, and to highlight the causes of post-PICU stay anemia, its course, and its association with post-PICU outcomes.
确定儿科重症监护病房（PICU）出院时贫血的患病率和风险标志物。
双中心回顾性队列研究。
法国两家多学科 PICU。
所有在 5 年内入住 PICU 至少 2 天且在 PICU 出院时可获得血红蛋白值的患儿。
无。
在参与的每个 PICU 的电子病历中回顾性收集患者、入院和 PICU 住院期间的特征。根据世界卫生组织标准定义贫血。在纳入分析的 3170 例患者中，1868 例（58.9%）在 PICU 出院时贫血。贫血患儿的比例因年龄类别而异，而中位血红蛋白水平则无明显的年龄差异。多变量调整后，PICU 入院时贫血是 PICU 出院时贫血的最强预测因素，且这种关联的强度因年龄而异（交互作用）。如果在 PICU 住院期间接受红细胞输注、年龄小于 6 个月或 PICU 入院时肌酐水平较低，则 PICU 入院时贫血的患儿发生 PICU 出院时贫血的风险降低。如果 PICU 入院时无贫血的患儿在 PICU 入院时血小板减少、C 反应蛋白水平较高、在 PICU 住院期间接受血浆输注、正性肌力/血管加压药物支持或机械通气，则发生 PICU 出院时贫血的风险增加。
儿科危重病后贫血很常见。PICU 入院时的贫血状况定义了具有不同特征的危重病患儿亚组，这些患儿在 PICU 出院时贫血的患病率和风险标志物具有特异性。需要进一步研究来证实我们的结果，以更好地定义儿科危重病期间的贫血，并强调 PICU 住院后贫血的原因、病程及其与 PICU 后结局的关系。
