Blood Product Transfusion Patterns in One Lithuanian and Two Polish Academic Emergency Departments: A Retrospective Comparative Study.
8 affiliations
- 1Emergency Medicine Department, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
- 2Emergency Department, Collegium Medicum, Nicolaus Copernicus University in Toruń, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland.
- 3Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
- 4Department of General and Minimally Invasive Surgery, Jan Biziel University Hospital No. 2, 85-168 Bydgoszcz, Poland.
- 5Department of Medical Rescue, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznań, Poland.
- 6Doctoral School, Poznan University of Medical Sciences, 10 Fredry Street, 61-701 Poznań, Poland.
- 7Department of Emergency Medicine, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznań, Poland.
- 8Department of Oncology and Hematology, Institute of Oncology, Lithuanian University of Health Sciences, Eivenių Str. 2, 50009 Kaunas, Lithuania.
Abstract
Background and Objectives: Blood product transfusion is an important emergency intervention for patients with acute bleeding, severe symptomatic anemia, and selected hematological conditions. Patterns of ED transfusion may differ according to the local case mix, referral pathways, and blood bank processes. We compared transfusion-related characteristics and outcomes among patients treated in one Lithuanian and two Polish academic emergency departments. Materials and Methods: We performed a retrospective comparative study of adults (aged ≥18 years) in whom a blood product transfusion was initiated in the ED between 1 January 2022 and 31 December 2024 at one Lithuanian and two Polish academic hospitals. We compared patient characteristics, indication categories, shock index values, time to transfusion, blood product use, adjunctive therapies, laboratory values, ED disposition, hospital length of stay, and in-hospital mortality. Findings are reported as center-cohort comparisons and are not intended to represent national practice. Results: A total of 670 patients were included: 367 at the Lithuanian center and 303 across the two Polish centers. GI bleeding was significantly more common in the Lithuanian center cohort (48.8% vs. 22.8%; OR 3.22 [95% CI 2.30-4.53]; p < 0.001), whereas anemia and malignancy-related anemia were more frequent in the Polish center cohort (anemia: 34.7% vs. 18.3%, OR 0.42 [95% CI 0.29-0.6]; p < 0.001; cancer: 26.4% vs. 7.6%, OR 0.23 [95% CI 0.15-0.37]; p < 0.001). The median shock index was significantly higher in the Lithuanian center cohort than in the Polish center cohort (0.9; [IQR 0.7-1.2] vs. 0.7; IQR 0.6-0.9; 0.2 [95% CI 0.1-0.3]; p < 0.001), and pre-transfusion hemoglobin was lower (64.5 g/L [IQR 50-86] vs. 119 g/L [IQR 83-139]; p < 0.001). Uncrossmatched RBC units were more frequently administered in the Lithuanian center cohort (133 (36.9%) vs. 47 (15.6%); OR 3.18 [95% CI 2.18-4.64]; p < 0.001), as was fresh frozen plasma (71 (19.5%) vs. 3 (1%); OR 24.23 [95% CI 7.55-77.8]; p < 0.001). Conversely, platelet transfusions were more common in the Polish center cohort (17 (4.6%) vs. 45 (14.9%), OR 0.28 [95% CI 0.16-0.5]; p < 0.001). The median time from ED arrival to transfusion was longer in the Lithuanian center cohort than in the Polish center cohort (150 [IQR 75-256] vs. 117 [IQR 103-154], 23 [95% CI 9-39]; p = 0.002). Hospital admission was significantly more frequent in the Lithuanian cohort than in the Polish cohort (350 (95.4%) vs. 112 (37.0%); p < 0.001). Among admitted patients, the median hospital length of stay was significantly longer in the Lithuanian cohort compared with the Polish cohort (6 days [IQR 3-11] vs. 1 day [IQR 1-5]; 95% CI for the difference 3-4; p < 0.001). In-hospital mortality was 33.5% (n = 123) in the Lithuanian cohort and 13.9% (n = 42) in the Polish cohort (OR 3.13 [95% CI 2.12-4.63]; p < 0.001). Conclusions: Among transfused patients in the three participating academic EDs, the case mix, blood product use, transfusion timing, and unadjusted outcomes differed substantially. These center-specific findings may inform future prospective studies of how referral pathways, clinical populations, and local transfusion processes influence ED blood product utilization. They do not establish differences in national practice, transfusion appropriateness, or causal effects on clinical outcomes.
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BibTeX
@article{damuleviciutė2026blood,
title = {{Blood Product Transfusion Patterns in One Lithuanian and Two Polish Academic Emergency Departments: A Retrospective Comparative Study.}},
author = {Gailė Damulevičiūtė and Kristina Blažienė and Jakub Nożewski and Greta Miškinaitė and Goda Monstavičiūė and Kinga Janiszewska and Tomasz Kłosiewicz and Dawid Woszczyk and Patryk Konieczka and Diana Remeikienė and Vytautas Aukštakalnis},
journal = {Medicina (Kaunas, Lithuania)},
year = {2026},
month = oct,
doi = {10.3390/medicina62101918},
url = {https://europepmc.org/article/MED/42942449},
note = {CC BY},
}
RIS
TY - JOUR
TI - Blood Product Transfusion Patterns in One Lithuanian and Two Polish Academic Emergency Departments: A Retrospective Comparative Study.
AU - Gailė Damulevičiūtė
AU - Kristina Blažienė
AU - Jakub Nożewski
AU - Greta Miškinaitė
AU - Goda Monstavičiūė
AU - Kinga Janiszewska
AU - Tomasz Kłosiewicz
AU - Dawid Woszczyk
AU - Patryk Konieczka
AU - Diana Remeikienė
AU - Vytautas Aukštakalnis
PY - 2026
DA - 2026/10/05
JO - Medicina (Kaunas, Lithuania)
DO - 10.3390/medicina62101918
UR - https://europepmc.org/article/MED/42942449
AB - Background and Objectives: Blood product transfusion is an important emergency intervention for patients with acute bleeding, severe symptomatic anemia, and selected hematological conditions. Patterns of ED transfusion may differ according to the local case mix, referral pathways, and blood bank processes. We compared transfusion-related characteristics and outcomes among patients treated in one Lithuanian and two Polish academic emergency departments. Materials and Methods: We performed a retrospective comparative study of adults (aged ≥18 years) in whom a blood product transfusion was initiated in the ED between 1 January 2022 and 31 December 2024 at one Lithuanian and two Polish academic hospitals. We compared patient characteristics, indication categories, shock index values, time to transfusion, blood product use, adjunctive therapies, laboratory values, ED disposition, hospital length of stay, and in-hospital mortality. Findings are reported as center-cohort comparisons and are not intended to represent national practice. Results: A total of 670 patients were included: 367 at the Lithuanian center and 303 across the two Polish centers. GI bleeding was significantly more common in the Lithuanian center cohort (48.8% vs. 22.8%; OR 3.22 [95% CI 2.30-4.53]; p < 0.001), whereas anemia and malignancy-related anemia were more frequent in the Polish center cohort (anemia: 34.7% vs. 18.3%, OR 0.42 [95% CI 0.29-0.6]; p < 0.001; cancer: 26.4% vs. 7.6%, OR 0.23 [95% CI 0.15-0.37]; p < 0.001). The median shock index was significantly higher in the Lithuanian center cohort than in the Polish center cohort (0.9; [IQR 0.7-1.2] vs. 0.7; IQR 0.6-0.9; 0.2 [95% CI 0.1-0.3]; p < 0.001), and pre-transfusion hemoglobin was lower (64.5 g/L [IQR 50-86] vs. 119 g/L [IQR 83-139]; p < 0.001). Uncrossmatched RBC units were more frequently administered in the Lithuanian center cohort (133 (36.9%) vs. 47 (15.6%); OR 3.18 [95% CI 2.18-4.64]; p < 0.001), as was fresh frozen plasma (71 (19.5%) vs. 3 (1%); OR 24.23 [95% CI 7.55-77.8]; p < 0.001). Conversely, platelet transfusions were more common in the Polish center cohort (17 (4.6%) vs. 45 (14.9%), OR 0.28 [95% CI 0.16-0.5]; p < 0.001). The median time from ED arrival to transfusion was longer in the Lithuanian center cohort than in the Polish center cohort (150 [IQR 75-256] vs. 117 [IQR 103-154], 23 [95% CI 9-39]; p = 0.002). Hospital admission was significantly more frequent in the Lithuanian cohort than in the Polish cohort (350 (95.4%) vs. 112 (37.0%); p < 0.001). Among admitted patients, the median hospital length of stay was significantly longer in the Lithuanian cohort compared with the Polish cohort (6 days [IQR 3-11] vs. 1 day [IQR 1-5]; 95% CI for the difference 3-4; p < 0.001). In-hospital mortality was 33.5% (n = 123) in the Lithuanian cohort and 13.9% (n = 42) in the Polish cohort (OR 3.13 [95% CI 2.12-4.63]; p < 0.001). Conclusions: Among transfused patients in the three participating academic EDs, the case mix, blood product use, transfusion timing, and unadjusted outcomes differed substantially. These center-specific findings may inform future prospective studies of how referral pathways, clinical populations, and local transfusion processes influence ED blood product utilization. They do not establish differences in national practice, transfusion appropriateness, or causal effects on clinical outcomes.
SN - 1010-660X
SN - 1648-9144
ER -