Title |
Two-year outcomes following a randomised platelet transfusion trial in preterm infants
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Published in |
Archives of Disease in Childhood -- Fetal & Neonatal Edition, February 2023
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DOI | 10.1136/archdischild-2022-324915 |
Pubmed ID | |
Authors |
Carmel Maria Moore, Angela D’Amore, Suzanne Fustolo-Gunnink, Cara Hudson, Alice Newton, Beatriz Lopez Santamaria, Alison Deary, Renate Hodge, Valerie Hopkins, Ana Mora, Charlotte Llewelyn, Vidheya Venkatesh, Rizwan Khan, Karen Willoughby, Wes Onland, Karin Fijnvandraat, Helen V New, Paul Clarke, Enrico Lopriore, Timothy Watts, Simon Stanworth, Anna Curley, Timothy Watts, Helen Broomfield, Beatriz Lopez Santamaria, Guy’s Anna Curley, Vidheya Venkatesh, Rizwan Khan, Gusztav Belteki, Heather Smethurst, Ajit Mahaveer, Nicola Booth, Imelda Mayor KarenDockery, Anna Hendrickson, Clare Clifford, Porus Bustani, Pauline Bayliss, Paul Clarke, Priya Muthukumar, Karen Few, Katherine Lloyd, Zoltan Molnar, Sheula Barlow, Sharon Baugh, Enrico Lopriore, Romy Berkhout, Helen McElroy, Helen Harizaj, Manobi Borooah, Rachel Jackson, Heather Barrow, Elizabeth Simcox, Sunit Godambe, Sara Barnett, Anton van Kaam, Wes Onland, Debbie Nuytemans, Simon Power, Claire Abbott, Patsy Graham, Oliver Rackham, Joanne Mullen, Sharon Hughes, Lucy Lewis, Sundeep Harigopal, Linda Smith, Julie Groombridge, Tracey Downes, Charlotte Huddy, Naomi Hayward, ShobhaCherian Vana Wardley, Mallinath Chakraborty, Sarah McCullough, Louise Woodhead, Joanne Reed, Chloe Rishton, Grainne O’Connor, Anna Curley, Rebekah Prabharan, Raju Narasimhan, Claire Lodge, Nikki Childs, Kylie Reid, Joanna Lees, Natalie Mattos-Harris, Mark van der Hoeven, C Harikumar, Wendy Cheadle, Alex Ramshaw, Julie Colarossi, Sharon Clarke, Anitha James, Mithilesh Lal, Amanda Forster, Helena Smith, Andre Kroon, Annelies Bos, Melanie Sutcliffe, Sharon Kempson, Nick Denyer, Lyndsay Bibb, Andy Cox, Heather Collier, Emily Andrews, Vimal Vasu, Shermi George, Claire Moloney, Esther d’Haens, Liesbeth Groot Jebbink-Akkerman, Paul Munyard, Barbara Bromage, Tim Scorrer, Tamsyn Wilson, Ellen de Kort, Tinneke Jonckers, Marieke Vervoorn, David Sweet, Patricia McCreesh, Sonia McKenna, Muriel Millar, David Grier, Mike Smith, Sara Gilpin, Judith Ratcliffe, Damien Armstrong, Julie Brown, Conor O’Neill, Willem de Boode, Wendy Jansen, Christopher Knight, Nicki Thorne, Kirsty O Brien, Taunton Susan Chatfield, Rachel Wane, Elizabeth Ingram, Christian Hulzebos, Annelies Olthuis, Anthony Ryan, Siobhan Foley, Carol Anne O’Shea, Karen Luyt, Joanne Innoles, Osama Hamud, Imran Ahmed, Natalie Talbot, Nicola Pritchard, Susan Hallett, Poonam Belani, Claudia Chetcutiganado, Yvonne Miller |
Abstract |
Assess mortality and neurodevelopmental outcomes at 2 years of corrected age in children who participated in the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion - 2/Management of Thrombocytopenia in Special Subgroup) study, which reported that a higher platelet transfusion threshold was associated with significantly increased mortality or major bleeding compared to a lower one. Randomised clinical trial, enrolling from June 2011 to August 2017. Follow-up was complete by January 2020. Caregivers were not blinded; however, outcome assessors were blinded to treatment group. 43 level II/III/IV neonatal intensive care units (NICUs) across UK, Netherlands and Ireland. 660 infants born at less than 34 weeks' gestation with platelet counts less than 50×109/L. Infants were randomised to undergo a platelet transfusion at platelet count thresholds of 50×109/L (higher threshold group) or 25×109/L (lower threshold group). Our prespecified long-term follow-up outcome was a composite of death or neurodevelopmental impairment (developmental delay, cerebral palsy, seizure disorder, profound hearing or vision loss) at 2 years of corrected age. Follow-up data were available for 601 of 653 (92%) eligible participants. Of the 296 infants assigned to the higher threshold group, 147 (50%) died or survived with neurodevelopmental impairment, as compared with 120 (39%) of 305 infants assigned to the lower threshold group (OR 1.54, 95% CI 1.09 to 2.17, p=0.017). Infants randomised to a higher platelet transfusion threshold of 50×109/L compared with 25×109/L had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. ISRCTN87736839. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 23 | 31% |
Australia | 7 | 9% |
Ireland | 6 | 8% |
United States | 6 | 8% |
Malaysia | 1 | 1% |
Netherlands | 1 | 1% |
India | 1 | 1% |
France | 1 | 1% |
Denmark | 1 | 1% |
Other | 2 | 3% |
Unknown | 25 | 34% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 42 | 57% |
Practitioners (doctors, other healthcare professionals) | 13 | 18% |
Scientists | 13 | 18% |
Science communicators (journalists, bloggers, editors) | 5 | 7% |
Unknown | 1 | 1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 24 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Unspecified | 4 | 17% |
Other | 2 | 8% |
Lecturer | 2 | 8% |
Librarian | 1 | 4% |
Professor | 1 | 4% |
Other | 3 | 13% |
Unknown | 11 | 46% |
Readers by discipline | Count | As % |
---|---|---|
Unspecified | 4 | 17% |
Medicine and Dentistry | 4 | 17% |
Social Sciences | 1 | 4% |
Psychology | 1 | 4% |
Unknown | 14 | 58% |