Transfusion Requirements in ESRD Patients Admitted with GI Hemorrhage Undergoing Inpatient Endoscopy

Area of Science:

• Nephrology
• Gastroenterology
• Transfusion Medicine

Background:

• Gastrointestinal (GI) hemorrhage is a serious complication in patients with end-stage renal disease (ESRD).
• Limited data exists on blood product utilization for ESRD patients with GI bleeding.
• Understanding transfusion needs and predictors is crucial for managing this high-risk population.

Purpose of the Study:

• To estimate blood product transfusion requirements in ESRD patients admitted with GI bleeding.
• To identify predictors of transfusion needs available at the time of admission.
• To evaluate the impact of comorbidities and clinical factors on transfusion practices.

Main Methods:

• Retrospective chart review of ESRD patients undergoing inpatient endoscopy for GI bleeding (2009-2015).
• Analysis of red blood cell (RBC), fresh frozen plasma (FFP), and platelet transfusion rates.
• Multivariate analysis to determine independent predictors of transfusion.

Main Results:

• ESRD patients received a mean of 2.9 RBC units; 28% received FFP, 8% received platelets.
• Predictors for RBC transfusion included elevated prothrombin time, low hemoglobin, ICU admission, heart failure, white race, and syncope.
• Prolonged prothrombin time predicted FFP transfusion; thrombocytopenia predicted platelet transfusion.

Conclusions:

• Patients with ESRD and GI bleeding have substantial blood transfusion requirements.
• Key predictors for transfusion are identifiable at admission, aiding in management.
• Transfusion needs were not predicted by standard mortality scores like Rockall.