Latona Akmez, Smith Emma, Grant James, Mitra Biswadev
Emergency Department Ipswich Hospital Ipswich Queensland Australia.
Statewide Anticoagulation Committee, Queensland Health Brisbane Queensland Australia.
EJHaem. 2025 Jul 10;6(4):e70101. doi: 10.1002/jha2.70101. eCollection 2025 Aug.
To describe the application of data linkage for analysing coagulation abnormalities and blood transfusion practices in patients with chronic liver disease (CLD) presenting to emergency departments (EDs).
Patients with CLD presenting to 104 Queensland Health EDs (January 2016-August 2023) were identified using International Classification of Diseases codes. Phase 1 deterministically linked ED, admission, pathology, transfusion and death records using unique identifiers. Phase 2 used Structured Query Language (SQL) to capture transfusion timing. The model incorporated data from both digital and non-digitalised hospitals.
Phase 1 linkage identified 36,643 ED presentations, 443,367 admissions, 47,357 deaths, 3,004,236 pathology results and 140,687 blood transfusion events. Phase 2 identified 23,578 ED presentations by 11,961 patients, linked to 20,312 admissions, 921 deaths, 22,284 full blood counts (FBC), 19,408 coagulation profiles, 3068 blood gases, 457 rotational thromboelastometry (ROTEM) and 53 thromboelastography tests. Transfusion data were linked to 1616 presentations, including of 1358 red blood cell (RBC) transfusion episodes, 330 fresh frozen plasma, 324 cryoprecipitate, 418 platelets, 51 fibrinogen concentrate and 280 Prothrombinex-VF administration episodes. High linkage rates were achieved for FBC (99.4%), coagulation profile (97.6%) and biochemistry (92.3%), while linkages for blood gas (34.6%), ROTEM (13.8%) and thromboelastography (2.5%) were less frequent. Massive transfusions occurred in 27 presentations (≥ 4 RBC units in 4 h) and in 22 presentations (≥ 10 RBC units in 24 h), with 100% linkage for FBC and coagulation profiles in both groups.
The feasibility of data linkage to investigate coagulation abnormalities and transfusion in CLD patients was demonstrated. This model provides a scalable method for haemovigilance and transfusion research.
The authors have confirmed clinical trial registration is not needed for this submission.
描述数据链接在分析就诊于急诊科（ED）的慢性肝病（CLD）患者凝血异常和输血情况中的应用。
利用国际疾病分类编码识别2016年1月至2023年8月期间就诊于昆士兰卫生系统104家急诊科的CLD患者。第一阶段使用唯一标识符确定性地链接急诊科、住院、病理、输血和死亡记录。第二阶段使用结构化查询语言（SQL）获取输血时间。该模型纳入了来自数字化医院和非数字化医院的数据。
第一阶段链接识别出36,643次急诊科就诊、443,367次住院、47,357例死亡、3,004,236份病理结果和140,687次输血事件。第二阶段识别出11,961名患者的23,578次急诊科就诊，与20,312次住院、921例死亡、22,284份全血细胞计数（FBC）、19,408份凝血谱、3068份血气分析、457次旋转血栓弹力图（ROTEM）和53次血栓弹力图检查相关联。输血数据与1616次就诊相关联，包括1358次红细胞（RBC）输血事件、330次新鲜冰冻血浆输血、324次冷沉淀输血、418次血小板输血、51次纤维蛋白原浓缩物输血和280次凝血酶原复合物-VF给药事件。FBC（99.4%）、凝血谱（97.6%）和生化检查（92.3%）的链接率较高，而血气分析（34.6%）、ROTEM（13.8%）和血栓弹力图（2.5%）的链接率较低。27次就诊（4小时内≥4个RBC单位）和22次就诊（24小时内≥10个RBC单位）发生了大量输血，两组FBC和凝血谱的链接率均为100%。
证明了数据链接用于研究CLD患者凝血异常和输血情况的可行性。该模型为血液监测和输血研究提供了一种可扩展的方法。
作者已确认本提交不需要临床试验注册。
