Document Detail

Recurrent bleeding in acute upper gastrointestinal hemorrhage: transfusion confusion.
MedLine Citation:
PMID:  17610783     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: Acute upper gastrointestinal (UGI) hemorrhage is a common, often serious condition encountered in the emergency department (ED). Previous research has suggested that transfusion of blood products may interfere with the hypercoagulable state induced by significant blood loss. Our objective was to determine whether the frequency of rebleeding is higher in patients with UGI bleeding who have received early blood transfusion.
METHODS: The study was a retrospective chart review of patients admitted to hospital through the ED with a diagnosis of UGI hemorrhage. Inclusion criteria limited analysis to patients presenting with hematemesis, melena, or bloody nasogastric aspirate, in whom a UGI lesion was confirmed endoscopically during admission.
RESULTS: A total of 214 charts were analyzed. Baseline demographic characteristics were similar in transfused and non-transfused patients. Presenting hemoglobin level was lower in the transfused group (86.5 v. 119.2 g/L, p < 0.001). Recurrent bleeding occurred in 99 (46%) patients and was more common in transfused patients (67 [66%] v. 33 [29%], p < 0.001). Logistic regression analysis revealed that transfusion and presenting hemoglobin level were the only variables with a statistically significant independent association with bleeding recurrence (p < 0.001 and p < 0.05 respectively).
CONCLUSIONS: Our results support previous research suggesting that transfused UGI bleed patients have a higher rate of rebleeding. However, because of the retrospective design, causality cannot be inferred.
J L Ginn; J Ducharme
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  CJEM : Canadian journal of emergency medical care = JCMU : journal canadien de soins médicaux d'urgence     Volume:  3     ISSN:  1481-8035     ISO Abbreviation:  CJEM     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2007-07-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100893237     Medline TA:  CJEM     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  193-8     Citation Subset:  -    
Discipline of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
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