| Title |
Effect of Transfusion Strategy in Acute Non‐variceal Upper Gastrointestinal Bleeding: A Nationwide Study of 5861 Hospital Admissions in Denmark
|
|---|---|
| Published in |
World Journal of Surgery, December 2015
|
| DOI | 10.1007/s00268-015-3370-4 |
| Pubmed ID | |
| Authors |
Rasmus Fabricius, Peter Svenningsen, Jens Hillingsø, Lars Bo Svendsen, Martin Sillesen |
| Abstract |
Acute non-variceal upper gastrointestinal bleeding (NVUGIB) is a common cause of admissions as well as aggressive transfusion of blood products. Whether the transfusion strategy in NVUGIB impacts on hemostasis is unknown and constitutes the focus of this study. Retrospective analysis of all hospital admissions in Denmark between 2011 and 2013 where hemostatic endoscopic interventions in either the stomach or duodenum had been employed. Regression modeling was used to predict the effect of units transfused of packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelets (PLT) on primary outcome 30-day mortality as well as secondary hemostasis-related outcomes and need for re-endoscopy and conversion to surgery. The model was corrected for confounders, including transfusion of other blood products (PRBC, FFP, and PLT, respectively), patient age as well as pre-existing medical conditions. 5107 patients received 10783 therapeutic endoscopic interventions. Units of PRBC transfused were identified as a predictor of re-endoscopy, surgery, and 30-day mortality with odds ratio (OR) 1.08 (1.06-1.09, p < 0.01), 1.05 (1.03-1.07, p < 0.01), and 1.04 (1.01-1.06, p < 0.01), respectively. Units of FFP transfused were associated with a higher risk of surgery and 30-day mortality with OR 1.05 (1.02-1.08, p < 0.01) and 1.04 (1.02-1.07, p < 0.01), respectively. Units of PLTs transfused were independently associated with a reduction in risk of re-endoscopy 0.93 (0.87-0.98, p = 0.02). A high ratio of PRBC:FFP:PLT (1:1:1) was associated with reduced need for re-endoscopy OR 0.23 (0.06-0.67, p = 0.01) but increased mortality with OR 3.60 (1.34-11.38, p = 0.02). PRBC transfusion was associated with adverse events, including 30-day mortality and failure of hemostasis. In contrast, transfusion of PLT was associated with a reduction in need for re-endoscopy. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 21 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 24% |
| Student > Master | 3 | 14% |
| Professor > Associate Professor | 3 | 14% |
| Researcher | 3 | 14% |
| Student > Ph. D. Student | 1 | 5% |
| Other | 2 | 10% |
| Unknown | 4 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 62% |
| Agricultural and Biological Sciences | 1 | 5% |
| Engineering | 1 | 5% |
| Unknown | 6 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 December 2015.
All research outputs
#20,298,249
of 22,835,198 outputs
Outputs from World Journal of Surgery
#3,797
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Outputs of similar age
#327,510
of 390,452 outputs
Outputs of similar age from World Journal of Surgery
#68
of 89 outputs
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