Transfusion Practices in Gastrointestinal Bleeding - a Tertiary Care Single-Centre Analysis.

Area of Science:

• Hematology
• Gastroenterology
• Transfusion Medicine

Background:

• Acute gastrointestinal bleeding (GIB) is a critical condition requiring prompt management.
• Transfusion therapy can be life-saving but should follow an individualized and restrictive approach.
• Current clinical guidelines advocate for conservative transfusion strategies in GIB.

Purpose of the Study:

• To analyze and evaluate transfusion practices for GIB patients over one year.
• To assess adherence to restrictive transfusion strategies in a tertiary hospital setting.
• To identify patterns in red blood cell (RBC) and other blood product utilization for GIB.

Main Methods:

• Retrospective analysis of GIB patients receiving transfusions in 2014.
• Data collection included patient demographics, GIB type, and transfusion details.
• Statistical analysis of transfusion triggers, product types, and quantities.

Main Results:

• 1005 GIB transfusion episodes in 494 patients were analyzed; upper GIB was more frequent.
• Median hemoglobin triggering RBC transfusion was 7.6 g/dL, with a median of 2 RBC units per episode.
• Only 7.3% of GIB episodes did not require RBC transfusion; patients needing Fibrinogen Concentrate (FC) and/or Prothrombin Complex Concentrate (PCC) received more blood products.

Conclusions:

• The hospital demonstrated a restrictive transfusion approach for GIB, aligning with current guidelines.
• RBC transfusions were the primary intervention, with limited use of other blood products in most cases.
• Patients requiring advanced hemostatic agents (FC/PCC) had higher overall blood product needs.