Outcome of Emergency Blood Transfusion in Children Seen at a Tertiary Children's Hospital in Freetown: A Descriptive Cross-sectional Study.

Objective: This study sought to describe the prevalence and clinical outcome after emergency blood transfusion among children presenting with severe anemia in a tertiary children's hospital in Sierra Leone.

Method: This was a retrospective study of 395 children who received emergency blood transfusion at the Ola During Children's Hospital in Freetown. Association between mortality and sociodemographic and clinical factors was assessed using χ 2 test. Statistical significance was set at P < 0.05.

Results: Three hundred ninety-five of 4719 children (8.4%) admitted to the emergency room of the Ola During Children's Hospital received emergency blood transfusion within 24 hours of presentation. Twenty-five (6.3%) were excluded because of incomplete data. The median age of the subjects was 24 months (interquartile range, 14-48). There were 191 boys (51.6%) and 179 girls (48.4%), giving a male/female ratio of 1.06:1. The most common indication for emergency transfusion was severe malaria anemia (67.8%). The mean hemoglobin concentration before transfusion was 4.8 g/dL (±1.4 g/dL). A total of 339 children (91.6%) were discharged home, 8 (2.2%) were discharged against medical advice, and 23 children (6.2%) died. The median length of stay on admission was 3 days (interquartile range, 2-5). Children with severe sepsis ( P < 0.001) and those with pretransfusion hemoglobin concentration less than 5% ( P = 0.047) were significantly more likely to die after transfusion compared with the other categories of patients. In a multivariate regression analysis, none of the factors were independently associated with clinical outcome after blood transfusion in children who received emergency blood transfusion.

Conclusion: The study suggests that emergency blood transfusion in children with severe anemia may improve in-hospital survival.