Title | Bleeding Scales Applicable to Critically Ill Children: A Systematic Review. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Nellis ME, Levasseur J, Stribling J, E Faustino VS, Zantek ND, Sheth S, Karam O |
Journal | Pediatr Crit Care Med |
Volume | 20 |
Issue | 7 |
Pagination | 603-607 |
Date Published | 2019 07 |
ISSN | 1529-7535 |
Keywords | Adult, Child, Critical Illness, Hemorrhage, Humans, Reproducibility of Results, Severity of Illness Index, Validation Studies as Topic |
Abstract | OBJECTIVES: To summarize current bleeding scales and their validation to assess applicability to bleeding in critically ill children. DATA SOURCES: We conducted electronic searches of Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and Web of Science Core Collection databases from database inception to 2017. STUDY SELECTION: Included studies contained a bleeding score, bleeding measurement tool, or clinical measurement of hemorrhage. DATA EXTRACTION: We identified 2,097 unique citations; 20 full-text articles were included in the final review. DATA SYNTHESIS: Of the 18 studies that included subjects (two others were expert consensus definitions), seven (39%) were pediatric-only, seven (39%) were adult-only, and four (22%) included both adults and children. Nine (50%) occurred with inpatients (two studies in critical care units), seven (39%) involved outpatients and two (11%) included both inpatients and outpatients. Thirty-nine percent of the scales were developed for those with idiopathic thrombocytopenic purpura and only two (12%) described critically ill patients. The majority (80%) included need for treatment (either RBC transfusion or surgical intervention). The majority (65%) did not report measures of reliability or validation to clinical outcomes. CONCLUSIONS: There is a lack of validated bleeding scales to adequately assess bleeding and outcomes in critically ill children. Validated scales of bleeding are necessary and urgently needed. |
DOI | 10.1097/PCC.0000000000001943 |
Alternate Journal | Pediatr Crit Care Med |
PubMed ID | 30925573 |