Effectiveness of blood transfusions and risk factors for mortality in children aged from 1 month to 4 years at the Bon Marché Hospital, Bunia, Democratic Republic of the Congo.

Auteurs: Mueller Y Bastard M Ehounou G Itama J Quéré M de la Tour R Vala L Etard JF Bottineau MC
Référence de l'article: Tropical medicine & international health : TM & IH 2012 Dec ; 17(12); 1457-64. doi: 10.1111/j.1365-3156.2012.03095.x. Epub 2012 10 11
Democratic Republic of the Congo RDC República Democrática del Congo blood transfusion facteurs de risque factores de riesgo mortalidad mortality mortalité paediatric pediatría pédiatrique risk factors transfusion sanguine transfusión de sangre
eng

Abstract

OBJECTIVE: To assess the effectiveness of blood transfusions in a hospital of north-eastern Democratic Republic of the Congo.

METHODS: Prospective study of children admitted for severe anaemia. During admission, data were collected on clinical condition and haemoglobin levels, before and after blood transfusion. A linear regression model was built to explore factors associated with haemoglobin level after transfusion. Risk factors for mortality were explored through multivariate logistic regression.

RESULTS: Haemoglobin level (Hb) was below 4 g/dl in 35% (230/657), between 4 and 6 g/dl in 58% (348/657) and at least 6 g/dl in another 6% (43/657) of the transfused children. A transfusion of 15 ml/kg of whole blood increased the Hb from 4.4 to 7.8 g/dl. Haemoglobin level after transfusion was associated with baseline Hb, quantity of delivered blood and history of previous transfusions. Overall case-fatality rate was 5.6% (37/657). Risk factors for deaths were co-morbidities such as chest infection, meningitis or malnutrition, Hb ≥ 6 g/dl, impaired consciousness or jugular venous distention on admission, and provenance.

CONCLUSION: Transfusion was a frequent practice, the use of which could clearly have been rationalised. While indications should be restricted, quantities of transfused blood should be adapted to needs.

© 2012 Blackwell Publishing Ltd.