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Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study

Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transf...

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Autores principales: Peyrony, Olivier, Gamelon, Danaé, Brune, Romain, Chauvin, Anthony, Ghazali, Daniel Aiham, Yordanov, Youri, Arsicaud, Aude, Gilleron, Pauline, Curac, Sonja, Richard, Marie-Caroline, Feral-Pierssens, Anne-Laure, Villoing, Barbara, Beaune, Sébastien, Goulet, Hélène, Fontaine, Jean-Paul, François, Anne, Pirenne, France
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199757/
https://www.ncbi.nlm.nih.gov/pubmed/34199655
http://dx.doi.org/10.3390/jcm10112475
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author Peyrony, Olivier
Gamelon, Danaé
Brune, Romain
Chauvin, Anthony
Ghazali, Daniel Aiham
Yordanov, Youri
Arsicaud, Aude
Gilleron, Pauline
Curac, Sonja
Richard, Marie-Caroline
Feral-Pierssens, Anne-Laure
Villoing, Barbara
Beaune, Sébastien
Goulet, Hélène
Fontaine, Jean-Paul
François, Anne
Pirenne, France
author_facet Peyrony, Olivier
Gamelon, Danaé
Brune, Romain
Chauvin, Anthony
Ghazali, Daniel Aiham
Yordanov, Youri
Arsicaud, Aude
Gilleron, Pauline
Curac, Sonja
Richard, Marie-Caroline
Feral-Pierssens, Anne-Laure
Villoing, Barbara
Beaune, Sébastien
Goulet, Hélène
Fontaine, Jean-Paul
François, Anne
Pirenne, France
author_sort Peyrony, Olivier
collection PubMed
description Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transfusion in January and February 2018. Descriptive statistics were reported. Logistic regression was performed to assess variables that were independently associated with a pre-transfusion Hb level ≥ 8 g/dL. Results: During the study period, 529 patients received RBC transfusion. The median age was 74 (59–85) years. The patients had a history of cancer or hematological disease in 185 (35.2%) cases. Acute bleeding was observed in the ED for 242 (44.7%) patients, among which 145 (59.9%) were gastrointestinal. Anemia was chronic in 191 (40.2%) cases, mostly due to vitamin or iron deficiency or to malignancy with transfusion support. Pre-transfusion Hb level was 6.9 (6.0–7.8) g/dL. The transfusion motive was not notified in the medical chart in 206 (38.9%) cases. In the multivariable logistic regression, variables that were associated with a higher pre-transfusion Hb level (≥8 g/dL) were a history of coronary artery disease (OR: 2.09; 95% CI: 1.29–3.41), the presence of acute bleeding (OR: 2.44; 95% CI: 1.53–3.94), and older age (OR: 1.02/year; 95% CI: 1.01–1.04). Conclusion: RBC transfusion in the ED was an everyday concern and involved patients with heterogeneous medical situations and severity. Pre-transfusion Hb level was rather restrictive. Almost half of transfusions were provided because of acute bleeding which was associated with a higher Hb threshold.
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spelling pubmed-81997572021-06-14 Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study Peyrony, Olivier Gamelon, Danaé Brune, Romain Chauvin, Anthony Ghazali, Daniel Aiham Yordanov, Youri Arsicaud, Aude Gilleron, Pauline Curac, Sonja Richard, Marie-Caroline Feral-Pierssens, Anne-Laure Villoing, Barbara Beaune, Sébastien Goulet, Hélène Fontaine, Jean-Paul François, Anne Pirenne, France J Clin Med Article Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transfusion in January and February 2018. Descriptive statistics were reported. Logistic regression was performed to assess variables that were independently associated with a pre-transfusion Hb level ≥ 8 g/dL. Results: During the study period, 529 patients received RBC transfusion. The median age was 74 (59–85) years. The patients had a history of cancer or hematological disease in 185 (35.2%) cases. Acute bleeding was observed in the ED for 242 (44.7%) patients, among which 145 (59.9%) were gastrointestinal. Anemia was chronic in 191 (40.2%) cases, mostly due to vitamin or iron deficiency or to malignancy with transfusion support. Pre-transfusion Hb level was 6.9 (6.0–7.8) g/dL. The transfusion motive was not notified in the medical chart in 206 (38.9%) cases. In the multivariable logistic regression, variables that were associated with a higher pre-transfusion Hb level (≥8 g/dL) were a history of coronary artery disease (OR: 2.09; 95% CI: 1.29–3.41), the presence of acute bleeding (OR: 2.44; 95% CI: 1.53–3.94), and older age (OR: 1.02/year; 95% CI: 1.01–1.04). Conclusion: RBC transfusion in the ED was an everyday concern and involved patients with heterogeneous medical situations and severity. Pre-transfusion Hb level was rather restrictive. Almost half of transfusions were provided because of acute bleeding which was associated with a higher Hb threshold. MDPI 2021-06-02 /pmc/articles/PMC8199757/ /pubmed/34199655 http://dx.doi.org/10.3390/jcm10112475 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Peyrony, Olivier
Gamelon, Danaé
Brune, Romain
Chauvin, Anthony
Ghazali, Daniel Aiham
Yordanov, Youri
Arsicaud, Aude
Gilleron, Pauline
Curac, Sonja
Richard, Marie-Caroline
Feral-Pierssens, Anne-Laure
Villoing, Barbara
Beaune, Sébastien
Goulet, Hélène
Fontaine, Jean-Paul
François, Anne
Pirenne, France
Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study
title Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study
title_full Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study
title_fullStr Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study
title_full_unstemmed Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study
title_short Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study
title_sort red blood cell transfusion in the emergency department: an observational cross-sectional multicenter study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199757/
https://www.ncbi.nlm.nih.gov/pubmed/34199655
http://dx.doi.org/10.3390/jcm10112475
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