TY - JOUR
T1 - Score for neonatal acute physiology and phlebotomy blood loss predict erythrocyte transfusions in premature infants
AU - Kling, Pamela J.
AU - Sullivan, Tara M.
AU - Leftwich, Margaret E.
AU - Roe, Denise J.
PY - 1997
Y1 - 1997
N2 - Objective: To test the hypothesis that utilization of a previously described measure of acuity (ie, the score for neonatal acute physiology [SNAP]) during the first 7 postnatal days predicts which infants with a birth weight of 1500 g or less received erythrocyte transfusions during the initial hospitalization. Design: Retrospective chart review. Setting: A regional tertiary care newborn intensive care trail at the Arizona Health Sciences Center, University Medical Center, Tucson. Materials: Medical records of premature infants (birth weight, ≤ 1500 g) who were admitted from October 1993 to January 1995. Main Outcome Measures: Occurrence or nonoccurrence of erythrocyte transfusion was determined in 47 infants who were compared for demographic information, phlebotomy blood loss, diagnoses, medications, and the SNAP at 0, 1, 2, and 7 days of life. Results: Infants with a birth weight of 1500 g or less received a mean±SD of 1.9±2.9 transfusions, with 22 (47%) of the infants given transfusions. Infants who were given transfusions vs those who were not given transfusions were of a lower mean±SD birth weight (971 ± 238 g vs 1272 ± 144 g; P<.001) and a lower gestational age (27.7 ± 1.6 weeks vs 30.7 ± 2.8 weeks; P<.001), and they had a greater mean phlebotomy blood loss (3.3 ± 1.6 mL/kg per day vs 1.4±0.5 mL/kg per day; P<.001) during the first postnatal week. The SNAP indexes in those who received transfusions were higher at 1,2, and 7 days of life (P=.03, P=.001, and P<.001, respectively). Using stepwise logistic regression, phlebotomy blood loss and the SNAP at 7 days of life were significant predictors of the number of transfusions. The logistic model predicted which infants had been administered transfusions with 86% sensitivity and 88% specificity. Conclusions: The efficacy and cost- effectiveness of recombinant human erythropoietin therapy in premature infants remain under study. As earlier treatment with recombinant human erythropoietin may be more efficacious, early identification of which infants currently undergo transfusion may identify those who will receive the greatest benefit from recombinant human erythropoietin therapy. The SNAP distinguished those infants who were given transfusions from those who did not receive transfusions, even after adjusting for phlebotomy blood loss.
AB - Objective: To test the hypothesis that utilization of a previously described measure of acuity (ie, the score for neonatal acute physiology [SNAP]) during the first 7 postnatal days predicts which infants with a birth weight of 1500 g or less received erythrocyte transfusions during the initial hospitalization. Design: Retrospective chart review. Setting: A regional tertiary care newborn intensive care trail at the Arizona Health Sciences Center, University Medical Center, Tucson. Materials: Medical records of premature infants (birth weight, ≤ 1500 g) who were admitted from October 1993 to January 1995. Main Outcome Measures: Occurrence or nonoccurrence of erythrocyte transfusion was determined in 47 infants who were compared for demographic information, phlebotomy blood loss, diagnoses, medications, and the SNAP at 0, 1, 2, and 7 days of life. Results: Infants with a birth weight of 1500 g or less received a mean±SD of 1.9±2.9 transfusions, with 22 (47%) of the infants given transfusions. Infants who were given transfusions vs those who were not given transfusions were of a lower mean±SD birth weight (971 ± 238 g vs 1272 ± 144 g; P<.001) and a lower gestational age (27.7 ± 1.6 weeks vs 30.7 ± 2.8 weeks; P<.001), and they had a greater mean phlebotomy blood loss (3.3 ± 1.6 mL/kg per day vs 1.4±0.5 mL/kg per day; P<.001) during the first postnatal week. The SNAP indexes in those who received transfusions were higher at 1,2, and 7 days of life (P=.03, P=.001, and P<.001, respectively). Using stepwise logistic regression, phlebotomy blood loss and the SNAP at 7 days of life were significant predictors of the number of transfusions. The logistic model predicted which infants had been administered transfusions with 86% sensitivity and 88% specificity. Conclusions: The efficacy and cost- effectiveness of recombinant human erythropoietin therapy in premature infants remain under study. As earlier treatment with recombinant human erythropoietin may be more efficacious, early identification of which infants currently undergo transfusion may identify those who will receive the greatest benefit from recombinant human erythropoietin therapy. The SNAP distinguished those infants who were given transfusions from those who did not receive transfusions, even after adjusting for phlebotomy blood loss.
UR - http://www.scopus.com/inward/record.url?scp=0031025719&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031025719&partnerID=8YFLogxK
U2 - 10.1001/archpedi.1997.02170380031005
DO - 10.1001/archpedi.1997.02170380031005
M3 - Article
C2 - 9006525
AN - SCOPUS:0031025719
VL - 151
SP - 27
EP - 31
JO - A.M.A. American journal of diseases of children
JF - A.M.A. American journal of diseases of children
SN - 2168-6203
IS - 1
ER -