Clinical Impact of Red Blood Cell Transfusion Location on Gastrointestinal Bleeding Outcomes: Emergency Department vs. Inpatient Unit

Background: Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). The optimal strategy for red blood cell suspension (RBCS) transfusion, including timing and location, remains unclear. This study aimed to evaluate the impact of transfusion location (ED vs. inpatient units) on mortality and hospital stay in patients with GI bleeding. Methods: A cross-sectional descriptive study was conducted in the ED of a tertiary care hospital. Patients admitted with GI bleeding between 1 June 2021, and 1 June 2023, who received RBCS transfusion were included. Data on demographics, laboratory parameters, transfusion details, and clinical outcomes were collected from the hospital information system. Logistic regression was used to identify mortality predictors. Results: A total of 244 patients were included. Patients transfused in the ED had a significantly shorter hospital stay compared to those transfused in inpatient units. However, mortality did not differ between the groups. Logistic regression identified age, albumin, hemoglobin, creatinine, and hospital stay as independent mortality predictors, while transfusion location was not significant. Conclusions: Early RBCS transfusion in the ED may reduce hospital stay but does not significantly impact mortality. Identifying mortality-associated factors is crucial for optimizing patient management. Further prospective studies are needed to clarify the role of transfusion location in GI bleeding outcomes.