Bleeding Scales Applicable to Critically Ill Children: A Systematic Review

Marianne E. Nellis, Julie Levasseur, Judy Stribling, E. Vincent S. Faustino, Nicole D. Zantek, Sujit Sheth, Oliver Karam

Research output: Contribution to journalReview article

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)603-607
Number of pages5
JournalPediatric Critical Care Medicine
Volume20
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Critical Illness
Hemorrhage
Inpatients
Outpatients
Library Science
Databases
Idiopathic Thrombocytopenic Purpura
Information Storage and Retrieval
Critical Care
MEDLINE
Pediatrics

Keywords

  • critical care
  • critical illness
  • hemorrhage
  • intensive care units
  • pediatrics
  • severity of illness

PubMed: MeSH publication types

  • Journal Article

Cite this

Nellis, M. E., Levasseur, J., Stribling, J., Faustino, E. V. S., Zantek, N. D., Sheth, S., & Karam, O. (2019). Bleeding Scales Applicable to Critically Ill Children: A Systematic Review. Pediatric Critical Care Medicine, 20(7), 603-607. https://doi.org/10.1097/PCC.0000000000001943

Bleeding Scales Applicable to Critically Ill Children : A Systematic Review. / Nellis, Marianne E.; Levasseur, Julie; Stribling, Judy; Faustino, E. Vincent S.; Zantek, Nicole D.; Sheth, Sujit; Karam, Oliver.

In: Pediatric Critical Care Medicine, Vol. 20, No. 7, 01.07.2019, p. 603-607.

Research output: Contribution to journalReview article

Nellis, ME, Levasseur, J, Stribling, J, Faustino, EVS, Zantek, ND, Sheth, S & Karam, O 2019, 'Bleeding Scales Applicable to Critically Ill Children: A Systematic Review', Pediatric Critical Care Medicine, vol. 20, no. 7, pp. 603-607. https://doi.org/10.1097/PCC.0000000000001943
Nellis, Marianne E. ; Levasseur, Julie ; Stribling, Judy ; Faustino, E. Vincent S. ; Zantek, Nicole D. ; Sheth, Sujit ; Karam, Oliver. / Bleeding Scales Applicable to Critically Ill Children : A Systematic Review. In: Pediatric Critical Care Medicine. 2019 ; Vol. 20, No. 7. pp. 603-607.
@article{afa673a5033c413d8cff0d4bf92d6454,
title = "Bleeding Scales Applicable to Critically Ill Children: A Systematic Review",
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.",
keywords = "critical care, critical illness, hemorrhage, intensive care units, pediatrics, severity of illness",
author = "Nellis, {Marianne E.} and Julie Levasseur and Judy Stribling and Faustino, {E. Vincent S.} and Zantek, {Nicole D.} and Sujit Sheth and Oliver Karam",
year = "2019",
month = "7",
day = "1",
doi = "10.1097/PCC.0000000000001943",
language = "English (US)",
volume = "20",
pages = "603--607",
journal = "Pediatric Critical Care Medicine",
issn = "1529-7535",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Bleeding Scales Applicable to Critically Ill Children

T2 - A Systematic Review

AU - Nellis, Marianne E.

AU - Levasseur, Julie

AU - Stribling, Judy

AU - Faustino, E. Vincent S.

AU - Zantek, Nicole D.

AU - Sheth, Sujit

AU - Karam, Oliver

PY - 2019/7/1

Y1 - 2019/7/1

N2 - 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.

AB - 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.

KW - critical care

KW - critical illness

KW - hemorrhage

KW - intensive care units

KW - pediatrics

KW - severity of illness

UR - http://www.scopus.com/inward/record.url?scp=85069272939&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069272939&partnerID=8YFLogxK

U2 - 10.1097/PCC.0000000000001943

DO - 10.1097/PCC.0000000000001943

M3 - Review article

C2 - 30925573

AN - SCOPUS:85069272939

VL - 20

SP - 603

EP - 607

JO - Pediatric Critical Care Medicine

JF - Pediatric Critical Care Medicine

SN - 1529-7535

IS - 7

ER -