Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding.
BACKGROUND: Acute upper gastrointestinal bleeding (AUGIB) accounts for 14% of RBC units transfused in the UK. In exsanguinating AUGIB the value of RBC transfusion is self evident, but in less severe bleeding its value is less obvious. AIM: To examine the relationship between early RBC transfusion,...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Jezik: | English |
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2010
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| _version_ | 1826291449825591296 |
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| author | Hearnshaw, SA Logan, R Palmer, K Card, T Travis, S Murphy, M |
| author_facet | Hearnshaw, SA Logan, R Palmer, K Card, T Travis, S Murphy, M |
| author_sort | Hearnshaw, SA |
| collection | OXFORD |
| description | BACKGROUND: Acute upper gastrointestinal bleeding (AUGIB) accounts for 14% of RBC units transfused in the UK. In exsanguinating AUGIB the value of RBC transfusion is self evident, but in less severe bleeding its value is less obvious. AIM: To examine the relationship between early RBC transfusion, re-bleeding and mortality following AUGIB, which is one of the most common indications for red blood cell (RBC) transfusion. METHOD: Data were collected on 4441 AUGIB patients presenting to UK hospitals. The relationship between early RBC transfusion, re-bleeding and death was examined using logistic regression. RESULTS: 44% were transfused RBCs within 12 hours of admission. In patients transfused with an initial haemoglobin of <8 g/dl, re-bleeding occurred in 23% and mortality was 13% compared with a re-bleeding rate of 15%, and mortality of 13% in those not transfused. In patients transfused with haemoglobin >8 g/dl, re-bleeding occurred in 24% and mortality was 11% compared with a re-bleeding rate of 6.7%, and mortality of 4.3% in those not transfused. After adjusting for Rockall score and initial haemoglobin, early transfusion was associated with a two-fold increased risk of re-bleeding (Odds ratio 2.26, 95% CI 1.76-2.90) and a 28% increase in mortality (Odds ratio 1.28, 95% CI 0.94-1.74). CONCLUSIONS: Early RBC transfusion in AUGIB was associated with a two-fold increased risk of re-bleeding and an increase in mortality, although the latter was not statistically significant. Although these findings could be due to residual confounding, they indicate that a randomized comparison of restrictive and liberal transfusion policies in AUGIB is urgently required. |
| first_indexed | 2024-03-07T02:59:33Z |
| format | Journal article |
| id | oxford-uuid:b07cc3eb-cb41-4d3d-a8d9-9ec932f8ee30 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:59:33Z |
| publishDate | 2010 |
| record_format | dspace |
| spelling | oxford-uuid:b07cc3eb-cb41-4d3d-a8d9-9ec932f8ee302022-03-27T03:56:53ZOutcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b07cc3eb-cb41-4d3d-a8d9-9ec932f8ee30EnglishSymplectic Elements at Oxford2010Hearnshaw, SALogan, RPalmer, KCard, TTravis, SMurphy, M BACKGROUND: Acute upper gastrointestinal bleeding (AUGIB) accounts for 14% of RBC units transfused in the UK. In exsanguinating AUGIB the value of RBC transfusion is self evident, but in less severe bleeding its value is less obvious. AIM: To examine the relationship between early RBC transfusion, re-bleeding and mortality following AUGIB, which is one of the most common indications for red blood cell (RBC) transfusion. METHOD: Data were collected on 4441 AUGIB patients presenting to UK hospitals. The relationship between early RBC transfusion, re-bleeding and death was examined using logistic regression. RESULTS: 44% were transfused RBCs within 12 hours of admission. In patients transfused with an initial haemoglobin of <8 g/dl, re-bleeding occurred in 23% and mortality was 13% compared with a re-bleeding rate of 15%, and mortality of 13% in those not transfused. In patients transfused with haemoglobin >8 g/dl, re-bleeding occurred in 24% and mortality was 11% compared with a re-bleeding rate of 6.7%, and mortality of 4.3% in those not transfused. After adjusting for Rockall score and initial haemoglobin, early transfusion was associated with a two-fold increased risk of re-bleeding (Odds ratio 2.26, 95% CI 1.76-2.90) and a 28% increase in mortality (Odds ratio 1.28, 95% CI 0.94-1.74). CONCLUSIONS: Early RBC transfusion in AUGIB was associated with a two-fold increased risk of re-bleeding and an increase in mortality, although the latter was not statistically significant. Although these findings could be due to residual confounding, they indicate that a randomized comparison of restrictive and liberal transfusion policies in AUGIB is urgently required. |
| spellingShingle | Hearnshaw, SA Logan, R Palmer, K Card, T Travis, S Murphy, M Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. |
| title | Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. |
| title_full | Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. |
| title_fullStr | Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. |
| title_full_unstemmed | Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. |
| title_short | Outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding. |
| title_sort | outcomes following early red blood cell transfusion in acute upper gastrointestinal bleeding |
| work_keys_str_mv | AT hearnshawsa outcomesfollowingearlyredbloodcelltransfusioninacuteuppergastrointestinalbleeding AT loganr outcomesfollowingearlyredbloodcelltransfusioninacuteuppergastrointestinalbleeding AT palmerk outcomesfollowingearlyredbloodcelltransfusioninacuteuppergastrointestinalbleeding AT cardt outcomesfollowingearlyredbloodcelltransfusioninacuteuppergastrointestinalbleeding AT traviss outcomesfollowingearlyredbloodcelltransfusioninacuteuppergastrointestinalbleeding AT murphym outcomesfollowingearlyredbloodcelltransfusioninacuteuppergastrointestinalbleeding |