Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia

Dou Lin Rose Sun; Allan Puran; Mohammed Al Nuaimi; Layla AlRiyami; Laura M Kinlin; Melanie Kirby-Allen; Sanjay Mahant; Peter J Gill; Cornelia M Borkhoff; Patricia C Parkin

doi:10.1016/j.jpeds.2023.113878

Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia

J Pediatr. 2024 Mar:266:113878. doi: 10.1016/j.jpeds.2023.113878. Epub 2023 Dec 20.

Authors

Affiliations

¹ Faculty of Medicine, University of Toronto, Toronto, Canada.
² Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Canada.
³ Division of Pediatric Hematology & Oncology, Tawam Hospital, Al-Ain, United Arab Emirates; Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
⁴ Division of Pediatric Hematology & Oncology, Tawam Hospital, Al-Ain, United Arab Emirates.
⁵ Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada.
⁶ Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada; Division of Pediatric Hematology Oncology, Hospital for Sick Children, Toronto, Canada.
⁷ Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁸ Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁹ Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. Electronic address: patricia.parkin@sickkids.ca.

PMID: 38135031
DOI: 10.1016/j.jpeds.2023.113878

Abstract

Current recommendations advise against blood transfusion in hemodynamically stable children with iron deficiency anemia. In an observational study of 125 children aged 6 through 36 months, hospitalized with iron deficiency anemia, we found that hemoglobin level predicted red blood cell transfusion (area under the curve 0.8862). A hemoglobin of 39 g/L had sensitivity 92% and specificity 72% for transfusion.

Keywords: area under the curve; hemodynamic instability; inpatient care; not in the title: hemoglobin; receiver operating curves; sensitivity; specificity; transfusion complications.

Publication types

Observational Study

MeSH terms

Anemia, Iron-Deficiency* / therapy
Blood Transfusion
Child, Preschool
Erythrocyte Transfusion
Hemoglobins / analysis
Humans
Infant

Substances

Hemoglobins