Predictive indicators for determining red blood cell transfusion strategies in the emergency department

Abstract

Background and importance Appropriate decision-making is critical for transfusions to prevent unnecessary adverse outcomes; however, transfusion in the emergency department (ED) can only be decided based on sparse evidence in a limited time window. Objectives This study aimed to identify factors associated with appropriate red blood cell (RBC) transfusion in the ED by analyzing retrospective data of patients who received transfusions at a single center. Outcome measures and analysis This study analyzed associations between transfusion appropriateness and sex, age, initial vital signs, an ED triage score [the Korean Triage and Acuity Scale (KTAS)], the length of stay, and the hemoglobin (Hb) concentration. Main results Of 10 490 transfusions, 10 109 were deemed appropriate, and 381 were considered inappropriate. A younger age (P < 0.001) and a KTAS level of 3–5 (P = 0.028) were associated with inappropriate transfusions, after adjusting for O2 saturation and the Hb level. Conclusions In this single-center retrospective study, younger age and higher ED triage scores were associated with the appropriateness of RBC transfusions.