1Sultan Sulaiman District Hospital, Serdang Bedagai District, North Sumatra,

Therapeutic platelet transfusions are often performed in pediatric patients with various indications. However, the platelet transfusion has potentially induced more harm than good for some patients. Therefore, its effectiveness needs to be evaluated. This study aimed to evaluate the clinical risk factors namely sepsis, splenomegaly, DIC (disseminated intravascular coagulation), severe bleeding and the history of platelet transfusion in the incidence of platelet refractoriness. This was a case-control study conducted over a 13-month period from August 1st, 2010 until September 30th, 2011 in Department of Pediatrics, Dr. Sardjito General Hospital, Yogyakarta. From a total of 1403 platelet transfusion episodes in 464 patients, 86 incidences of refractoriness and 86 of nonrefractoriness were observed. Bivariate analysis showed that sepsis [OR = 5.91 (2.90-12.05); p = 0.000], splenomegaly [OR = 2.82 (1.32-6.04); p = 0.006], severe bleeding [OR = 8.41 (4.19-16.871); p = 0.000], DIC [OR = 22.96 (6.73-78.35); p = 0.000] and the history of platelet transfusions [OR= 5.33 (2.78-10.23); p = 0.000] increased the risk of platelets refractoriness. Furthermore, multivariate analysis showed that sepsis (OR = 2.96; 95%CI: 1.19-7.32; p = 0.019), splenomegaly (OR=3.94; 95 % CI: 2.21-16.00; p = 0.000), severe bleeding (OR = 3.53; 95 % CI: 1.40-8.89; p = 0.008), DI