Abstract：
Studies of organ dysfunction in children are limited by a lack of consensus around organ dysfunction criteria.
To derive evidence-informed, consensus-based criteria for hematologic dysfunction in critically ill children.
Data sources included PubMed and Embase from January 1992 to January 2020.
Studies were included if they evaluated assessment/scoring tools to screen for hematologic dysfunction and assessed outcomes of mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. Studies of adults or premature infants, animal studies, reviews/commentaries, small case series, and non-English language studies with inability to determine eligibility were excluded.
Data were abstracted from each eligible study into a standard data extraction form along with risk of bias assessment.
Twenty-nine studies were included. The systematic review supports the following criteria for hematologic dysfunction: thrombocytopenia (platelet count <100000 cells/µL in patients without hematologic or oncologic diagnosis, platelet count <30000 cells/µL in patients with hematologic or oncologic diagnoses, or platelet count decreased ≥50% from baseline; or leukocyte count <3000 cells/µL; or hemoglobin concentration between 5 and 7 g/dL (nonsevere) or <5 g/dL (severe).
Most studies evaluated pre-specified thresholds of cytopenias. No studies addressed associations between the etiology or progression of cytopenias overtime with outcomes, and no studies evaluated cellular function.
Hematologic dysfunction, as defined by cytopenia, is a risk factor for poor outcome in critically ill children, although specific threshold values associated with increased mortality are poorly defined by the current literature.
To derive evidence-informed, consensus-based criteria for hematologic dysfunction in critically ill children.
Data sources included PubMed and Embase from January 1992 to January 2020.
Studies were included if they evaluated assessment/scoring tools to screen for hematologic dysfunction and assessed outcomes of mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. Studies of adults or premature infants, animal studies, reviews/commentaries, small case series, and non-English language studies with inability to determine eligibility were excluded.
Data were abstracted from each eligible study into a standard data extraction form along with risk of bias assessment.
Twenty-nine studies were included. The systematic review supports the following criteria for hematologic dysfunction: thrombocytopenia (platelet count <100000 cells/µL in patients without hematologic or oncologic diagnosis, platelet count <30000 cells/µL in patients with hematologic or oncologic diagnoses, or platelet count decreased ≥50% from baseline; or leukocyte count <3000 cells/µL; or hemoglobin concentration between 5 and 7 g/dL (nonsevere) or <5 g/dL (severe).
Most studies evaluated pre-specified thresholds of cytopenias. No studies addressed associations between the etiology or progression of cytopenias overtime with outcomes, and no studies evaluated cellular function.
Hematologic dysfunction, as defined by cytopenia, is a risk factor for poor outcome in critically ill children, although specific threshold values associated with increased mortality are poorly defined by the current literature.
摘要：
儿童器官功能障碍的研究由于缺乏关于器官功能障碍标准的共识而受到限制。
为了获得证据，危重患儿血液学功能障碍的共识标准.
数据来源包括1992年1月至2020年1月的PubMed和Embase。
如果研究评估/评分工具以筛选血液学功能障碍和评估死亡率的结果，则纳入研究。功能状态，器官特异性结果，或其他以患者为中心的结果。成人或早产儿的研究，动物研究,评论/评论，小案例系列,和无法确定资格的非英语语言研究被排除。
将每个符合条件的研究中的数据提取到标准的数据提取表格中，并进行偏倚风险评估。
纳入29项研究。系统评价支持以下血液学功能障碍的标准：血小板减少症（无血液学或肿瘤学诊断的患者的血小板计数<100000个细胞/µL，血液或肿瘤诊断患者的血小板计数<30000细胞/微升，或血小板计数比基线下降≥50%;或白细胞计数<3000个细胞/µL;或血红蛋白浓度在5-7g/dL之间(非重度)或<5g/dL(重度).
大多数研究评估了预定的血细胞减少阈值。没有研究涉及随时间推移血细胞减少的病因或进展与结局之间的关联，没有研究评估细胞功能。
血液功能障碍，根据血细胞减少症的定义，是危重儿童预后不良的危险因素，尽管目前的文献对与死亡率增加相关的具体阈值定义不明确.
为了获得证据，危重患儿血液学功能障碍的共识标准.
数据来源包括1992年1月至2020年1月的PubMed和Embase。
如果研究评估/评分工具以筛选血液学功能障碍和评估死亡率的结果，则纳入研究。功能状态，器官特异性结果，或其他以患者为中心的结果。成人或早产儿的研究，动物研究,评论/评论，小案例系列,和无法确定资格的非英语语言研究被排除。
将每个符合条件的研究中的数据提取到标准的数据提取表格中，并进行偏倚风险评估。
纳入29项研究。系统评价支持以下血液学功能障碍的标准：血小板减少症（无血液学或肿瘤学诊断的患者的血小板计数<100000个细胞/µL，血液或肿瘤诊断患者的血小板计数<30000细胞/微升，或血小板计数比基线下降≥50%;或白细胞计数<3000个细胞/µL;或血红蛋白浓度在5-7g/dL之间(非重度)或<5g/dL(重度).
大多数研究评估了预定的血细胞减少阈值。没有研究涉及随时间推移血细胞减少的病因或进展与结局之间的关联，没有研究评估细胞功能。
血液功能障碍，根据血细胞减少症的定义，是危重儿童预后不良的危险因素，尽管目前的文献对与死亡率增加相关的具体阈值定义不明确.
