Pediatric anesthesia & critical care
Transfusion and outcomes in paediatric surgical patients: an 11-year retrospective North American cohort study
Authors' conclusion
We describe the incidence of RBC transfusion and associated mortality over a decade for paediatric patients undergoing noncardiac surgery.
Study context
- Population
- Patients aged 0–18 yr undergoing noncardiac surgery, American College of Surgeons NSQIP paediatric databases, 2012–23
- Participants
- 1,303,500 patients
- Exposure
- Perioperative red blood cell (RBC) transfusion vs no transfusion
- Transfusedn = 82,742
- Outcome
- Incidence of perioperative RBC transfusion
- Follow-up
- Intraoperatively up to 72 h after surgery
Methodological detailsmulticentre registry
- Multicentre registry
Main finding
As reported in the abstract
Transfused
6.3%
82 742
Observational data: associations, not effects.
Further findings
30-day mortality
- 30-day mortality — Difference in 30-day mortality, transfused vs not transfused (adjusted P-value)
- <0.001
Independent association between transfusion and 30-day mortality (multivariable)
- aOR for 30-day death with vs without blood transfusion
- 2.11 (95% CI 1.95-2.27)
Transfusion exposure by age
- Neonates
- 13.3%
- Older children (≥12 yr old)
- 9.6%
30-day mortality by age
- Neonates
- 14.9%
- Children aged 1-6 yr
- 1.4%
Safety
- More complications in transfused patients, distinct for higher volumes given
- adjusted P-value <0.001
- For all comparisons
Original publication
Transfusion and outcomes in paediatric surgical patients: an 11-year retrospective North American cohort study. Br J Anaesth. Published 21 November 2025. doi:10.
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