ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2020
Transfusion, mortality and hemoglobin level: Associations among emergency department patients in Kigali, Rwanda.
Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 9 citations in OpenAlex.
- In-hospital stay of anemic patients in the ED with/without transfusion: a single-center propensity-matched study.BMC emergency medicine · 2025Article
- Red blood cell transfusion in a tertiary Haitian hospital's emergency department: patient characteristics and availability challenges.International journal of emergency medicine · 2024Article
- Prediction of anemia in real-time using a smartphone camera processing conjunctival images.PloS one · 2024Article
- Clinical emergency care quality indicators in Africa: a scoping review and data summary.BMJ open · 2023Article
- Mortality and its associated factors in transfused patients at a tertiary hospital in Uganda.PloS one · 2022Article
- Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study.Journal of clinical medicine · 2021Article
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies 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.
methodsThis 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.
resultsOf 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.
conclusionsNo 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.
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