Jurnal Internasional Afrika vol. 10 issue 2 2020
African Journal of Emergency Medicine
Transfusion, mortality and hemoglobin level: Associations among emergency department patients in Kigali, Rwanda
Dublin Core
Title
Jurnal Internasional Afrika vol. 10 issue 2 2020
African Journal of Emergency Medicine
Transfusion, mortality and hemoglobin level: Associations among emergency department patients in Kigali, Rwanda
African Journal of Emergency Medicine
Transfusion, mortality and hemoglobin level: Associations among emergency department patients in Kigali, Rwanda
Subject
Blood
Transfusion
Mortality
Rwanda
LMIC
Emergency
Anemia
Hemoglobin
Transfusion
Mortality
Rwanda
LMIC
Emergency
Anemia
Hemoglobin
Description
Background: Studies from high-income countries (HIC) support restrictive blood transfusion thresholds in
medical patients. In low- and middle-income countries (LMIC), the etiologies of anemia and baseline health
states differ greatly; optimal transfusion thresholds are unknown. This study evaluated the association of packed
red blood cell (PRBC) transfusion with mortality outcomes across hemoglobin levels amongst emergency center
(EC) patients presenting with medical pathology in Kigali, Rwanda.
Methods: This retrospective cohort study was performed using a random sample of patients presenting to the EC
at the University Teaching Hospital of Kigali. Patients ≥15 years of age, treated for medical emergencies during
2013–16, with EC hemoglobin measurements were included. The relationship between EC PRBC transfusion and
patient mortality was evaluated using logistic regression, with stratified analyses performed at hemoglobin levels
of 7 mg/dL and 5 mg/dL.
Results: Of 3609 cases sampled, 1116 met inclusion. The median age was 42 years (IQR 29, 60) and 45.2% were
female. Transfusion occurred in 12.1% of patients. Hematologic (24.4%) and gastrointestinal pathologies
(20.7%) were the primary diagnoses of those transfused. Proportional mortality was higher amongst those receiving
transfusions, although not statistically significant (23.7% vs 17.0%, p=0.06). No significant difference
in adjusted odds of overall mortality by PRBC transfusion was found. In stratified analysis, patients receiving EC
transfusions with a hemoglobin >5.0 mg/dL, had 2.21 times the odds of mortality (95% CI 1.51–3.21) as
compared to those ≤5.0 mg/dL.
Conclusions: No association between PRBC transfusion and odds of mortality was observed amongst EC patients
in this LMIC setting. An increased mortality association was found for patients receiving PRBC transfusions with
an initial hemoglobin >5 mg/dL. Results suggest benefits from PRBC transfusion are limited as compared to
HIC. Further research evaluating emergent transfusion thresholds for medical pathologies should be performed
in LMICs to guide practice.
medical patients. In low- and middle-income countries (LMIC), the etiologies of anemia and baseline health
states differ greatly; optimal transfusion thresholds are unknown. This study evaluated the association of packed
red blood cell (PRBC) transfusion with mortality outcomes across hemoglobin levels amongst emergency center
(EC) patients presenting with medical pathology in Kigali, Rwanda.
Methods: This retrospective cohort study was performed using a random sample of patients presenting to the EC
at the University Teaching Hospital of Kigali. Patients ≥15 years of age, treated for medical emergencies during
2013–16, with EC hemoglobin measurements were included. The relationship between EC PRBC transfusion and
patient mortality was evaluated using logistic regression, with stratified analyses performed at hemoglobin levels
of 7 mg/dL and 5 mg/dL.
Results: Of 3609 cases sampled, 1116 met inclusion. The median age was 42 years (IQR 29, 60) and 45.2% were
female. Transfusion occurred in 12.1% of patients. Hematologic (24.4%) and gastrointestinal pathologies
(20.7%) were the primary diagnoses of those transfused. Proportional mortality was higher amongst those receiving
transfusions, although not statistically significant (23.7% vs 17.0%, p=0.06). No significant difference
in adjusted odds of overall mortality by PRBC transfusion was found. In stratified analysis, patients receiving EC
transfusions with a hemoglobin >5.0 mg/dL, had 2.21 times the odds of mortality (95% CI 1.51–3.21) as
compared to those ≤5.0 mg/dL.
Conclusions: No association between PRBC transfusion and odds of mortality was observed amongst EC patients
in this LMIC setting. An increased mortality association was found for patients receiving PRBC transfusions with
an initial hemoglobin >5 mg/dL. Results suggest benefits from PRBC transfusion are limited as compared to
HIC. Further research evaluating emergent transfusion thresholds for medical pathologies should be performed
in LMICs to guide practice.
Creator
Katelyn Moretti,, Catalina González Marqués, Stephanie Garbern, Gabin Mbanjumucyo, Chantal Uwamahoro, Francesca L. Beaudoin, Siraj Amanullah, Annie Gjelsvik, Adam R. Aluisio
Source
www.elsevier.com/locate/afjem
Date
9 January 2020
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Katelyn Moretti,, Catalina González Marqués, Stephanie Garbern, Gabin Mbanjumucyo, Chantal Uwamahoro, Francesca L. Beaudoin, Siraj Amanullah, Annie Gjelsvik, Adam R. Aluisio, “Jurnal Internasional Afrika vol. 10 issue 2 2020
African Journal of Emergency Medicine
Transfusion, mortality and hemoglobin level: Associations among emergency department patients in Kigali, Rwanda,” Repository Horizon University Indonesia, accessed November 22, 2024, https://repository.horizon.ac.id/items/show/2441.
African Journal of Emergency Medicine
Transfusion, mortality and hemoglobin level: Associations among emergency department patients in Kigali, Rwanda,” Repository Horizon University Indonesia, accessed November 22, 2024, https://repository.horizon.ac.id/items/show/2441.