Title: Hemoglobin levels and postoperative outcome in pediatric surgical patients
Background: Postoperative outcome in children is multifactorial. Among the reported predictors of postoperative outcome, preoperative anemia has been related to adverse outcome in children. A secondary analysis was undertaken to determine the correlation between hemoglobin levels and postoperative outcome in children included in a cohort of an observational pediatric study published previously since this analysis has not been done.
Objective: To determine the correlation between preoperative, intra-operative, postoperative hemoglobin levels and postoperative outcome in children in neurosurgery, abdominal and orthopedic surgery. Methods: Secondary analysis of a sub-cohort of 252 pediatric surgical patients with a median age of 62 months 12.50-144.00.
Results: Preoperative hemoglobin levels were negatively correlated to length of stay in the intensive care unit (LOSICU) (p=0.002), to length of hospital stay (LOS) (p<0.0001), to the number of patients with intra-operative and/or postoperative complications (p<0.0001) and to resurgery (p<0001). Low preoperative hemoglobin levels below 6 g/dL were correlated to higher postoperative LOSICU and LOS. Intra-operative hemoglobin levels were negatively correlated to LOS (p<0.0001) and to the number of patients with intra-operative and/or postoperative complications (p=0.004). Low intraoperative hemoglobin levels below 5 g/dL were correlated to higher LOS. Postoperative hemoglobin levels were positively correlated to LMV (p=0.002).
Conclusion: Hemoglobin levels are among other multifactorial predictors of postoperative outcome in pediatric surgical patients emphasizing the importance of a global patient blood management implementation program to improve outcome in surgical children.
Keywords: Anemia, hemoglobin levels, pediatric surgery, postoperative outcome, patient blood management, transfusion.
Claudine Kumba graduated as Medical Doctor in 2001, completed her specialization in Anesthesiology in 2006 at the Université Libre de Bruxelles, ULB, Brussels, Belgium. She has a Pediatric Anesthesia specialization graduation since 2010 from University of AixMarseille, France. She has a specialization graduation in Echocardiography applied to Anesthesia and Critical Care from University of Montpellier 1, 2011-2012, France. She has a Critical Care Medicine specialization graduation since 2014 from University of Montpellier 1, France. She is a Medical Doctor in Pediatric Anesthesia- Critical Care in Necker Enfants-Malades University Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris, France