+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Appropriate use of red blood cell transfusion in emergency departments: a study in five emergency departments

Appropriate use of red blood cell transfusion in emergency departments: a study in five emergency departments

Blood Transfusion 15(3): 199-206

Transfusion of blood components continues to be an important therapeutic resource into the 21st century. Between 5 and 58% of transfusions carried out are estimated to be unnecessary. According to several studies, at least 20% of packed red blood cell transfusions (RBCT) are administered in hospital emergency departments (ED), but few data are available about the appropriateness of RBCT in this setting. This multicentre, cross-sectional observational study aims to assess the appropriateness of RBCT indications and transfused volumes in patients who attend ED. The study cohort is made up of consecutive consenting adult patients (≥18 years old) who received RBCT in ED over a 3-month period and for whom relevant clinical data were collected and analysed. Data from 908 RBCT episodes (2±1 units per transfused patient) were analysed. RBCT was considered appropriate in 21.4% (n=195), with significant differences according to RBCT indication (p<0.001), hospital level (p<0.001) and prescribing physician (p=0.002). Pre-transfusion haemoglobin level (Hb) negatively correlated with RBCT appropriateness (r=-0.616; p<0.01). Only 72.4% of appropriate RBCT had a post-transfusion Hb assessment (n=516). Of these, 45% were considered to be over-transfused (n=232), with significant differences according to RBCT indication (p=0.012) and prescribing physician (p=0.047). Overall, 584/1,433 (41%) of evaluable RBC units were unnecessarily transfused. The appropriateness of RBCT in ED is similar to other hospital departments, but the rate of over-transfusion was high. These data support the need for a reassessment after transfusion of each RBC unit before further units are prescribed. In view of these results, we recommend that physicians should be made more aware of the need to prescribe RBCT appropriately in order to reduce over-transfusion.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 057226268

Download citation: RISBibTeXText

PMID: 27416566

Related references

Comparative throughput at freestanding emergency departments versus hospital-based emergency departments: A pilot study. American Journal of Emergency Medicine 36(8): 1508-1509, 2018

Faintness in emergency departments is frequent, benign but expensive: An epidemiologic study of hospitalization's risk factors to reduce overcrowdings of emergency departments. La Revue de Medecine Interne 38(1): 8-16, 2016

Emergency departments in The Netherlands: is there a difference in emergency departments with and without emergency physicians? a cross-sectional web-based survey. International Journal of Emergency Medicine 6(1): 11, 2013

Comparing Freestanding Emergency Departments, Hospital-Based Emergency Departments, and Urgent Care in Texas: Apples, Oranges, or Lemons?. Annals of Emergency Medicine 70(6): 858-861, 2017

Visits coded as intimate partner violence in emergency departments: characteristics of the individuals and the system as reported in a national survey of emergency departments. Journal of Emergency Nursing: Jen 34(5): 419-427, 2008

System-level health disparities in California emergency departments: minorities and Medicaid patients are at higher risk of losing their emergency departments. Annals of Emergency Medicine 59(5): 358-365, 2012

Pediatric emergency departments are more likely than general emergency departments to treat asthma exacerbation with systemic corticosteroids. Journal of Asthma 48(1): 69-74, 2011

Freestanding emergency departments in Texas do not alleviate congestion in hospital-based emergency departments. American Journal of Emergency Medicine 2019, 2019

Adherence to the guideline 'Triage in emergency departments': a survey of Dutch emergency departments. Journal of Clinical Nursing 20(17-18): 2458-2468, 2011

Small rural emergency departments are not simply cut-down large urban emergency departments. Australian Journal of Rural Health 17(6): 291, 2010

An Observational Study of Dyspnea in Emergency Departments: The Asia, Australia, and New Zealand Dyspnea in Emergency Departments Study (AANZDEM). Academic Emergency Medicine 24(3): 328-336, 2016

Cut-off values of B-type natriuretic peptide for the diagnosis of congestive heart failure in patients with dyspnoea visiting emergency departments: a study on Korean patients visiting emergency departments. Emergency Medicine Journal 24(5): 343-347, 2007

Emergency airway management in Australian and New Zealand emergency departments: A multicentre descriptive study of 3710 emergency intubations. Emergency Medicine Australasia 29(5): 499-508, 2017

Overcrowding in medium-volume emergency departments: effects of aged patients in emergency departments on wait times for non-emergent triage-level patients. International Journal of Nursing Practice 16(3): 310-317, 2010

Brief case management versus usual care for frequent users of emergency departments: the Coordinated Access to Care from Hospital Emergency Departments (CATCH-ED) randomized controlled trial. Bmc Health Services Research 16(1): 432, 2017