| The hematocrit level in upper gastrointestinal hemorrhage: safety of endoscopy and outcomes. | |
| | |
MedLine Citation:
|
PMID: 21962318 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVE: In patients with acute upper gastrointestinal hemorrhage, standard practice is to transfuse packed red blood cells, often to an arbitrary level of hemoglobin or hematocrit (typically 10 g/dL and 30%, respectively) before endoscopy. Therefore, we aimed to determine first whether performing endoscopy in patients with upper gastrointestinal hemorrhage and a low hematocrit is safe and whether it predicts outcomes. METHODS: This cohort study included patients with carefully defined upper gastrointestinal hemorrhage captured in our gastrointestinal Healthcare Registry who underwent esophagogastroduodenoscopy. Patients were placed into 2 groups: low hematocrit (<30%) or high hematocrit (>30%). Clinical variables and outcomes, including cardiovascular events, intensive care unit transfer, and death, were measured. RESULTS: A total of 920 patients meeting entry criteria were identified. Baseline features among those with a low and high hematocrit were identical. Eight cardiovascular events occurred during or after esophagogastroduodenoscopy, including 5 of 587 (1%) in the less than 30% hematocrit group and 3 of 333 (1%) in the greater than 30% hematocrit group (P=.29). Blood transfusions were more common in the low hematocrit group (74% vs 24%, P<.001). However, correlation between the amount of blood transfused and hematocrit level was poor, and the number units of blood transfused was highly variable. There was no significant mortality difference in the 2 hematocrit groups. CONCLUSION: Most patients with upper gastrointestinal hemorrhage presented with a hematocrit less than 30%. Performing endoscopy in patients with a low hematocrit was clearly safe; these data strongly imply that waiting for the hematocrit to reach a certain level before endoscopy is not necessary. |
| | |
Authors:
|
Valeska Balderas; Rafia Bhore; Luis F Lara; Julia Spesivtseva; Don C Rockey |
Related Documents
:
|
3808648 - Pure-tone audiometry of patients with auditory brainstem response abnormalities. 20640578 - Involvement of the human ventrolateral thalamus in olfaction. 9118838 - Sternocleidomastoid muscle responses to transcranial magnetic stimulation in patients w... 15140608 - Long-latency reflexes in patients with behçet's disease. 2742228 - Sepsis and antithrombin iii, prekallikrein, and fibronectin levels in surgical patients. 7438398 - Electrophysiologic delineation of the intraventricular his bundle in two patients with ... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The American journal of medicine Volume: 124 ISSN: 1555-7162 ISO Abbreviation: Am. J. Med. Publication Date: 2011 Oct |
Date Detail:
|
Created Date: 2011-10-03 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
|
Languages: eng Pagination: 970-6 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Digestive and Liver Diseases, the University of Texas Southwestern Gastrointestinal Bleed Team, University of Texas-Southwestern Medical Center, the Parkland Health and Hospital System, Dallas, Tex. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: N-Terminal Pro B-Type Natriuretic Peptide Identifies Patients with Chest Pain at High Long-term Card...
Next Document: Short-term Efficacy and Safety of Vasopressin Receptor Antagonists for Treatment of Hyponatremia.