用于确定急诊科红细胞输血策略的预测指标。
Predictive indicators for determining red blood cell transfusion strategies in the emergency department.
机构信息
Department of Laboratory Medicine.
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
出版信息
Eur J Emerg Med. 2023 Aug 1;30(4):260-266. doi: 10.1097/MEJ.0000000000001032. Epub 2023 Apr 28.
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 O 2 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.
背景和重要性
适当的决策对于输血至关重要，以防止不必要的不良后果；然而，在急诊科（ED）只能在有限的时间窗口内根据稀疏的证据来决定输血。
目的
本研究旨在通过分析单一中心接受输血的患者的回顾性数据，确定与 ED 中红细胞（RBC）输血适当性相关的因素。
结果测量和分析
本研究分析了输血适当性与性别、年龄、初始生命体征、ED 分诊评分[韩国分诊和急症量表（KTAS）]、住院时间和血红蛋白（Hb）浓度之间的关系。
主要结果
在 10490 次输血中，10109 次被认为是适当的，381 次被认为是不适当的。调整了 O 2 饱和度和 Hb 水平后，年龄较小（P ＜0.001）和 KTAS 水平为 3-5（P ＝0.028）与输血不适当相关。
结论
在这项单中心回顾性研究中，年龄较小和较高的 ED 分诊评分与 RBC 输血的适当性相关。
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