Predicting change of hemoglobin after transfusion in hemodynamically stable anemic patients in emergency department.
BACKGROUND
To investigate factors associated with change of post-transfusion hemoglobin level, and to derive an equation that predicts post-transfusion changes in hemoglobin levels in hemodynamically stable anemic patients who visited emergency department.


METHODS
A retrospective medical record review of patients who were hemodynamically stable and transfused with packed red blood cells was undertaken. Patients were randomly divided into two groups. One group (derivation group, 70% of total patients) was analyzed for factors associated with changes in post-transfusion hemoglobin levels, and linear regression analysis was performed to derive a prediction equation. The derived prediction equation was then externally validated with the other group (validation group, 30% of total patients).


RESULTS
A total of 196 patients were enrolled. The 137 patients (70% of total patients) in the derivation group were analyzed for factors associated with changes in post-transfusion hemoglobin. Of those, body surface area and initial hemoglobin level were significantly correlated with changes in post-transfusion hemoglobin levels (p < 0.05). From these variables, linear regression analysis resulted in a prediction equation. The derived equation was validated externally with the 59 patients (30% of total patients) in the validation group and found to have an excellent correlation (r = 0.73, intraclass correlation = 0.84, p < 0.05).


CONCLUSIONS
Post-transfusion hemoglobin level in hemodynamically stable adult patients was associated with initial hemoglobin levels and body surface area. These factors must be considered when transfusing hemodynamically stable adult patients with anemia.
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
Jae Hyuk
JH
Lee
Dong Hoon
DH
Kim
Kyuseok
K
Kim
Joong Eui
JE
Rhee
Tae Youn
TY
Kim
You Hwan
YH
Jo
Jin Hee
JH
Lee
Gil Joon
GJ
Suh
Seung Sik
SS
Hwang
Christopher C
CC
Lee
Adam J
AJ
Singer
D000328:Adult; D000368:Aged; D000740:Anemia / Q000503:physiopathology / Q000628:therapy*; D001830:Body Surface Area; D004636:Emergency Service, Hospital; D017707:Erythrocyte Transfusion; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D006454:Hemoglobins