Correlates of emergency response interval and mortality from severe anaemia in childhood

Abstract

A retrospective study to determine the influence of blood transfusion emergency response interval on Mortality from childhood severe anaemia was carried out. Admission records of all children with severe anaemia over a 5-year period was reviewed. Those who either died before transfusion or got discharged against medical advice were excluded. A total of 5790 patients were admitted during the 5 year period. Ten percent (10%) had severe anaemia. Malaria, the leading cause of anaemia in this series, was found in 80% of the patients. Twenty patients (3.3%) died before transfusion while 50 discharged from the hospital against medical advice. There was male preponderance. Ages 2-5 years were the peak age group for severe anaemia. No patient had haematocrit less than 5% but 20 (4.2%) had heaematocrit above 20%. The hospital stay for majority (74.8%) of the patients was 72 hours or less. Mortality (Case fatality) increases with increase in transfusion emergency response interval within 24 hours. Based on the transfusion emergency response interval versus mortality curve, a mortality risk assessment scores were derived for use in clinical practice to determine the risk of dying from the disease. We recommend that national or hospital policy on blood transfusion be enunciated to ensure that all patient with severe anaemia get transfused within 2 hours of diagnosis.