Scholarlink

Background <p>Sepsis-associated acute kidney injury (SA-AKI) is a severe pediatric condition often requiring red blood cell transfusion, yet its transfusion risk factors remain unclear. This study investigated the incidence, temporal trends, and determinants of transfusion in children with SA-AKI.</p> Methods <p>Using the U.S. Nationwide Inpatient Sample (2010–2019), pediatric patients (&lt; 18&#xa0;years) with SA-AKI were identified by ICD-9/10 codes. Demographic, hospital, comorbidity, and complication data were compared and then analyzed using multivariate logistic regression to identify independent risk factors for transfusion.</p> Results <p>Among 7,521 children with SA-AKI, 30.17% received transfusions. The annual transfusion rate declined from 45.6% (2010) to 21.6% (2019). Independent risk factors included younger age, Black/Hispanic/Asian race, higher comorbidity burden, teaching hospital admission, elective admission, and Northeast hospital location. Specific comorbidities (coagulopathy, disseminated intravascular coagulation, lymphoma, fluid/electrolyte disorders, neurological disorders, and solid tumor without metastasis) and complications (continuous trauma ventilation, acute respiratory failure, gastrointestinal bleeding, thrombocytopenia, septic shock, hepatic insufficiency) significantly increased transfusion likelihood. Protective factors included chronic pulmonary disease, uncomplicated diabetes, paralysis, and urinary tract infection.</p> Conclusion <p>Pediatric SA-AKI transfusion rates have markedly decreased over the past decade. Risk factors reflect disease severity and acute complications, while certain chronic conditions appear protective. These findings highlight the complexity of transfusion decision-making in SA-AKI and may inform strategies to optimize transfusion practices.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Blood transfusion in pediatric sepsis-associated acute kidney injury: a nationwide study of risk factors and outcomes

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月24日

查看全文
  • Jiaying Gao,
  • Youfang Zhang,
  • Lu Chen,
  • Wenxiu Song,
  • Huan Hou,
  • Changwei Yi,
  • Yuexian He,
  • Bo Huang

摘要

Background

Sepsis-associated acute kidney injury (SA-AKI) is a severe pediatric condition often requiring red blood cell transfusion, yet its transfusion risk factors remain unclear. This study investigated the incidence, temporal trends, and determinants of transfusion in children with SA-AKI.

Methods

Using the U.S. Nationwide Inpatient Sample (2010–2019), pediatric patients (< 18 years) with SA-AKI were identified by ICD-9/10 codes. Demographic, hospital, comorbidity, and complication data were compared and then analyzed using multivariate logistic regression to identify independent risk factors for transfusion.

Results

Among 7,521 children with SA-AKI, 30.17% received transfusions. The annual transfusion rate declined from 45.6% (2010) to 21.6% (2019). Independent risk factors included younger age, Black/Hispanic/Asian race, higher comorbidity burden, teaching hospital admission, elective admission, and Northeast hospital location. Specific comorbidities (coagulopathy, disseminated intravascular coagulation, lymphoma, fluid/electrolyte disorders, neurological disorders, and solid tumor without metastasis) and complications (continuous trauma ventilation, acute respiratory failure, gastrointestinal bleeding, thrombocytopenia, septic shock, hepatic insufficiency) significantly increased transfusion likelihood. Protective factors included chronic pulmonary disease, uncomplicated diabetes, paralysis, and urinary tract infection.

Conclusion

Pediatric SA-AKI transfusion rates have markedly decreased over the past decade. Risk factors reflect disease severity and acute complications, while certain chronic conditions appear protective. These findings highlight the complexity of transfusion decision-making in SA-AKI and may inform strategies to optimize transfusion practices.

Graphical abstract