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Updated: Sep 16, 2025
Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
Published on: August 4, 2018
Coagulation and Transfusion Informatics in Chronic Liver Disease: A Data Linkage Study of Emergency Department
Akmez Latona1,2,3,4,5, Emma Smith6, James Grant7
1Emergency Department Ipswich Hospital Ipswich Queensland Australia.
Insights
Data linkage effectively analyzed coagulation issues and blood transfusions in chronic liver disease (CLD) patients presenting to emergency departments. This scalable model enhances haemovigilance and transfusion research for better patient outcomes.
Area of Science:
- Medical Informatics
- Clinical Pathology
- Hepatology
Background:
- Chronic liver disease (CLD) is associated with complex coagulation abnormalities.
- Effective management of CLD patients in emergency departments (EDs) requires understanding transfusion practices.
- Current data systems may present challenges in linking patient records for comprehensive analysis.
Purpose of the Study:
- To demonstrate the application of data linkage for analyzing coagulation abnormalities.
- To evaluate blood transfusion practices in patients with CLD presenting to EDs.
- To develop a scalable model for haemovigilance and transfusion research in CLD.
Main Methods:
- Utilized deterministic and SQL-based data linkage across ED, admission, pathology, transfusion, and death records for CLD patients.
- Integrated data from both digital and non-digitalized hospitals in Queensland Health EDs.
- Linked various pathology results including full blood counts (FBC), coagulation profiles, and specific transfusion events.
Main Results:
- Successfully linked a large volume of patient data, including over 36,000 ED presentations and 140,000 transfusion events.
- Achieved high linkage rates for critical tests like FBC (99.4%) and coagulation profiles (97.6%).
- Identified massive transfusions in 27 presentations (≥4 RBC units/4h) and 22 presentations (≥10 RBC units/24h) with complete FBC and coagulation profile linkage.
Conclusions:
- Data linkage is a feasible and effective method for investigating coagulation abnormalities and transfusion practices in CLD patients.
- The developed model offers a scalable solution for haemovigilance and transfusion research.
- This approach can improve the understanding and management of bleeding risks in CLD.
Objective:
To describe the application of data linkage for analysing coagulation abnormalities and blood transfusion practices in patients with chronic liver disease (CLD) presenting to emergency departments (EDs).
Methods:
Patients with CLD presenting to 104 Queensland Health EDs (January 2016-August 2023) were identified using International Classification of Diseases codes. Phase 1 deterministically linked ED, admission, pathology, transfusion and death records using unique identifiers. Phase 2 used Structured Query Language (SQL) to capture transfusion timing. The model incorporated data from both digital and non-digitalised hospitals.
Results:
Phase 1 linkage identified 36,643 ED presentations, 443,367 admissions, 47,357 deaths, 3,004,236 pathology results and 140,687 blood transfusion events. Phase 2 identified 23,578 ED presentations by 11,961 patients, linked to 20,312 admissions, 921 deaths, 22,284 full blood counts (FBC), 19,408 coagulation profiles, 3068 blood gases, 457 rotational thromboelastometry (ROTEM) and 53 thromboelastography tests. Transfusion data were linked to 1616 presentations, including of 1358 red blood cell (RBC) transfusion episodes, 330 fresh frozen plasma, 324 cryoprecipitate, 418 platelets, 51 fibrinogen concentrate and 280 Prothrombinex-VF administration episodes. High linkage rates were achieved for FBC (99.4%), coagulation profile (97.6%) and biochemistry (92.3%), while linkages for blood gas (34.6%), ROTEM (13.8%) and thromboelastography (2.5%) were less frequent. Massive transfusions occurred in 27 presentations (≥ 4 RBC units in 4 h) and in 22 presentations (≥ 10 RBC units in 24 h), with 100% linkage for FBC and coagulation profiles in both groups.
Conclusion:
The feasibility of data linkage to investigate coagulation abnormalities and transfusion in CLD patients was demonstrated. This model provides a scalable method for haemovigilance and transfusion research.
Trial Registration:
The authors have confirmed clinical trial registration is not needed for this submission.
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