Outcomes following restrictive or liberal red blood cell transfusion in patients with lower gastrointestinal bleeding

Alimentary Pharmacology & Therapeutics
O KheradV Jairath

Abstract

Restrictive red blood cell (RBC) transfusion reduces mortality and rebleeding after upper gastrointestinal bleeding (UGIB). However, there is no evidence to guide transfusion strategies in lower gastrointestinal bleeding (LGIB). To assess the association between RBC transfusion strategies and outcomes in patients with LGIB METHODS: This was a post hoc analysis of the UK National Comparative Audit of LGIB and the Use of Blood. The relationships between liberal RBC transfusion and clinical outcomes of rebleeding, mortality and a composite outcome for safe discharge were examined. Transfusion strategy was dichotomised and defined as "liberal" when transfusion was administered for haemoglobin (Hb) ≥80 g/L (or ≥90 g/L in patients with acute coronary syndrome) or major haemorrhage, and "restrictive" otherwise. Multivariable logistic regression models were used to assess the independent association between liberal RBC transfusion and outcomes. Of 2528 consecutive patients enrolled from 143 hospitals in the original study, 666 (26.3%) received RBC transfusion (mean age 73.3 ± 16 years, 49% female, initial mean haemoglobin 90 ± 24 g/L, 2.3% had haemodynamic instability). The rebleeding rate in transfused patients was 42.3%. After adjust...Continue Reading

References

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Citations

Mar 15, 2019·Alimentary Pharmacology & Therapeutics·Omar Kherad, Vipul Jairath
Mar 15, 2019·Alimentary Pharmacology & Therapeutics·Ali S Taha
Jan 30, 2021·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Franco RadaelliLorenzo Fuccio
Jan 7, 2021·Digestive Diseases and Sciences·Truman J MillingNeil Sengupta

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