Patient's performance status should dictate transfusion strategy in nonvariceal acute upper gastrointestinal bleeding (NV-AUGIB): A prospective multicenter cohort study: Transfusion strategy in NV-AUGIB.
Dig Liver Dis
; 52(10): 1156-1163, 2020 10.
Article
en En
| MEDLINE
| ID: mdl-32788141
ABSTRACT
BACKGROUND:
Non-variceal acute UGI bleeding (NV-AUGIB) is a frequent indication for transfusion, but the best hemoglobin threshold and target values for transfusion in relation to the patients' performance status are unknown.OBJECTIVE:
To identify threshold and target hemoglobin levels for transfusion favoring survival of patients with NV-AUGIB stratified by ASA score.DESIGN:
Prospective cohort study.SETTING:
50 hospitals of the Italian National Health Service.PARTICIPANTS:
2758 consecutive patients with NV-AUGIB admitted to 50 Italian hospitals from January 1st, 2014 to December 31st, 2015. Five hemoglobin cut-off values were evaluated.RESULTS:
30-days mortality overall 5.4%; ASA 1-2 patients 2.5%; ASA 3-4 patients 10.8%. Mortality was higher when hemoglobin at admission was ≤ 7â¯g/dL in ASA 1-2 patients, and when it was ≤ 8â¯g/dL in ASA 3-4 patients. The hemoglobin levels after transfusion favouring survival were ≥ 8â¯g/dL in ASA 1-2, p <0.0001 and 9-10â¯g/dL in ASA 3-4 patients; pâ¯=â¯0.0002.CONCLUSIONS:
In patients with NV-AUGIB the physical performance status should dictate the transfusion strategy. In ASA 1-2 patients, admission hemoglobin values ≤ 7â¯g/dL should prompt transfusion, aiming at a target value of 8-9â¯g/dL; the corresponding figures for ASA 3-4 patients are admission hemoglobin level ≤ 8â¯g/dL and target value of 9-10â¯g/dL.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Transfusión Sanguínea
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Hemorragia Gastrointestinal
Tipo de estudio:
Clinical_trials
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Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Humans
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Dig Liver Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2020
Tipo del documento:
Article