VPB0251 - An Analysis of Factors influencing Survival of Bleeding Patients During First Two Years of Life

Background: Plasma, platelet transfusion threshold are difficult to interpret in early childhood due to developmental differences and pathogenesis of disease as compared to adults.Clinical diagnosis such as ongoing sepsis can interfere with transfusions and subsequent patient prognosis.

Aims: Aims of present study were as follows:
1. Gestational age and APGAR score effect patient survival in Plasma and/or Platelet transfused <= 2-year hospital admissions.
2. Children (<=2years) with sepsis have an adverse prognosis with platelet and/or plasma transfusions.

Methods: All Calculations were performed on 2021 Minitab software.
Patient age, weight, gestational age; Length of stay (LOS) were correlated with death. Gestational age (<=34 weeks;>34 weeks) (n=72) and APGAR score 5 minutes (<=7;>7) (n=62) ; Preterm; term children and sepsis with remaining diagnoses for death were evaluated by Binary logistic regression (Odds ratio).

Results: In this observational study (n=104), median age (SD) months 1.0(IQR 6.9) ; (<=1 month, n=60,>1 month, n=44); median LOS 11.0d (16.0d).Preterm {0.23(IQR 0.67 months);(n=33)};term {3.0 (IQR 11.7 months) (n= 73)}; median gestational age 38.0 (n=72){(IQR 6.0weeks);(<=34weeks, n=23);(>34 weeks, n=49)} respectively.A total of 47 deaths with 57 survivors. Median LOS was 11.0(IQR 16.0)days.
Age, weight were not significant in correlation (-0.031; -0.219; P=0.74; P=0.19) ; gestational age <=34 weeks (-0.23; P=0.013); Apgar score 5 minutes (-0.35; P=0.005) and LOS (-0.23; P=0.018) correlated significantly with death.
Odds ratio of Gestational age (<=34 wk.;>34) 2.21; CI (0.7 – 6.4), P=0.14; APGAR score 5 minutes (<=7;>7) 12.3; CI (0.9;160.4); P=0.054 and Preterm at birth was 2.2(0.8-5.4); P=0.087 with death.
Sepsis compared to remaining diagnosis had Odds ratio of 10.3; CI (3.8, 27.8); P< 0.01 for death during hospital stay.

Conclusion(s): 1. Prognosis of plasma and platelet transfusions in newborn is influenced by gestational age and Apgar score.
2. Sepsis patients are resistant to platelet and/or plasma therapy with worse prognosis as compared to patients without clinical sepsis.