Clinical, demographic characteristics and factors affecting mortality of patients WHO are applicable to the emergency medicine clinic and have blood and blood products transfusion

Purpose: It was aimed to evaluate the clinical and laboratory findings, the frequency and distribution of post-transfusion complications in patients who presented to the emergency department with a transfusion indication. Materials and Methods: Male and female patients aged 18 and over who applied to Dicle University Medical Faculty Hospital Adult Emergency Service between 01.01.2020-31.12.2020 will be formed. In this retrospective, descriptive study, the files of approximately 370 patients were scanned and the clinical and demographic characteristics of the patients (age, gender, date of application and season), blood groups (0Rh-,0Rh+,ARh-,ARh+,BRh-,BRh+,ABRh-,ABRh+) , diagnoses (gis bleeding, anemia, trauma, malignancy), causes of transfusion (volume replacement, Hb increase, INR decrease, transfusion, hematological disease), blood product and amount used (ERS, FFP, thrombocyte, whole blood) laboratory parameters: Replacement Before and after (Hb, hct, Plt, INR) complications, patient outcome (outpatient treatment, hospitalization, intensive care hospitalization, emergency surgery, discharge and ex) will be examined. The effectiveness of these parameters on mortality will be investigated by examining. The conformity of continuous variables to the normal distribution was examined using the Shapiro-Wilk test. Continuous variables using mean ± standard deviation or median (minimum: maximum) values; categorical variables were expressed as n(%). According to the normality test results, Mann Whitney U test was used for comparisons between groups. Categorical variables were analyzed using the Chi-square test. SPSS (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) program was used for statistical analysis, and type I error level was accepted as 5% in statistical analysis. Results: Patients who met the criteria for blood and blood product transfusion were included in the study. The mean age of the patients was 51.2±22.2 years, 144 (44.9%) women and 177 (55.1%) men. The most common diagnoses of the patients were anemia in 23.4%, trauma in 22.7%, GIS bleeding in 19.9%, malignancy in 19.3% and hematological disease in 14.6%. The most common causes of transfusion were 47.9% increased HB, 28.7% transfusion, 18.1% lower INR, 17.8% volume replacement, and 9.4% hematological disease. found as Fever was found in 28 (8.7%) patients, volume overload in 19 (5.9%) and urticaria in 15 (4.7%) patients. 110 (34.3%) of the patients were hospitalized, 109 (33.9%) were hospitalized in the intensive care unit, 42 (13.1%) were operated, 39 (12.2%) were discharged with outpatient treatment. and 21 (6.5%) of them resulted in mortality. The median Hgb change after transfusion was found to be 2.4 (minimum: -1-maximum: 7.7) in patients who underwent ERS transfusion (p<0.001). The median Hgb change after transfusion was found to be 1.5 (minimum:-2.5-maximum:7.7) in patients who received platelet transfusion (p=0.004). The median Hgb change after transfusion was found to be 1.6 (minimum:-2.9-maximum:6.9) in patients who received FFP transfusion (p<0.001). The median Hct change after transfusion was 6.9 (minimum:-4-maximum:24.8) in patients who received ERS transfusion (p<0.001). The median Hct change after transfusion was found to be 4.5 (minimum:-5.8-maximum:24.8) in patients who received platelet transfusion (p=0.010). The median Hct change after transfusion was found to be 4.5 (minimum: 10.3-maximum:21) in patients who received FFP transfusion (p<0.001). The median Plt change after transfusion was 33 (minimum: -118.4-maximum: 182) in patients who received platelet transfusion (p<0.001). The median Inr change after transfusion was found as -0.2 (minimum: 14.6-maximum: 0.3) in patients who received FFP transfusion (p<0.001). While 93.4% of the patients who developed complications had ERS unit blood, 6.6% did not have ERS unit blood (p=0.023). Conclusion: Transfusions that will not provide significant benefit while transfusion of blood and blood products should be avoided considering their complications. Key Words: emergency services, blood transfusion, complication