Retrospective analysis of blood and blood product transfusions in the emergency department

Objective: In emergency departments, blood or blood product transfusion is indicated for patients with acute severe bleeding and/or hypovolemic shock due to bleeding. In addition, blood or blood product transfusion is frequently administered to patients who present to the emergency department with different complaints and diagnoses and who are found to have severe low levels of blood or blood components. Since emergency physicians are responsible for the administration of blood or blood product transfusion therapy and its complications, they should have sufficient knowledge and skills on this subject. Our aim in this study was to determine the demographic, clinical and laboratory characteristics of patients who received blood or blood product transfusion in our emergency department, to determine the data related to blood or blood products used in the emergency department and to contribute to the literature on this subject. Patients and Methods: We retrospectively analysed the data of 909 patients who were admitted to our Emergency Department between January 2020 and December 2020 and who received blood and blood product transfusion. Patients under the age of 18 years, patients transfused with albumin and protein complex concentrate were excluded from the study. In our study, demographic, clinical and laboratory characteristics of patients who received blood and blood product transfusions in the emergency department were analysed, as well as the characteristics, amount and place of supply of blood and blood products. The study was carried out retrospectively and single-centre. Data were analysed with IBM SPSS v23. Results and Discussion: Of the 909 patients included in the study, 492 (54.1%) were female and 417 (45.9%) were male. The mean age of the patients was 67.8 years. In general, we found that transfusions were administered at a higher rate in women than in men and this rate was higher in women over 65 years of age. When the complaints of the patients who received transfusions were analysed, 36.9% of the patients presented with bleeding, 20.9% with fatigue and 3.3% with trauma. In the emergency department, erythrocyte suspension was administered most frequently (45.4%) and gastrointestinal system (GIS) haemorrhage (25.4%). The most 8 frequently transfused blood group was A Rh (+) (42.7%) and the least frequently transfused blood group was AB Rh (-) (5.3%). The average blood product transfused to the patients was two units and the mean Hb value of the patients before transfusion was 7.97 g/dl. 90.9% of the blood products used were successfully transfused to the patients. All of the transfusion-related adverse reactions were reported as febrile non-haemolytic transfusion reaction (FNHTR) and all developed against erythrocyte suspensions. Intensive care was required in 51% of the transfused patients. The mortality rate of our study was 45.4%. Conclusion: It was determined that, blood and blood product transfusions in the emergency department were most commonly administered to female patients over 65 years of age, the most common complaints of the patients presenting to the emergency department were bleeding and fatigue, transfusions were most commonly performed in trauma in young patients and in low blood levels due to gastrointestinal bleeding in geriatric patients, the mean haemoglobin value of the patients before transfusion was 7.97 g/dl, an average of two units of blood and blood products were transfused to the patients, the most frequently transfused blood product was erythrocyte suspension, the most frequently used blood group was A RH (+) and the least frequently used blood group was AB RH (-), the most frequently successfully transfused blood product was erythrocyte suspension, the most frequently wasted and recycled blood product was fresh frozen plasma, and the most frequently adverse reaction related to transfusion was febrile non-haemolytic transfusion reaction.