Predictive indicators for determining red blood cell transfusion strategies in the emergency department

Background and importanceAppropriate 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. ObjectivesThis 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 analysisThis 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 resultsOf 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. ConclusionsIn this single-center retrospective study, younger age and higher ED triage scores were associated with the appropriateness of RBC transfusions.