Investigating Haemoglobin Thresholds for Red Blood Cell Transfusion in Patients with Acute Upper GI Bleeding
Abstract
Red blood cell transfusion is frequently used to treat the harmful effects of anemia in patients with acute upper gastrointestinal bleeding. However, there is no clear consensus on when red blood cell transfusion is warranted. No studies thus far have defined the optimal threshold for transfusion, and none have looked at whether volume of blood transfused is associated with clinical outcome. This thesis attempts to addresses these gaps by analyzing hemoglobin and volume of blood transfused as predictors of patient outcomes using multivariable logistic regression models. Main results showed a statistically significant interaction between initial hemoglobin and whether a patient received a transfusion, suggesting no apparent benefit to receiving a transfusion above hemoglobin concentrations of approximately 10.5g/dL. Risk of adverse outcomes also increased with increasing volume of blood transfused. These results could contribute to improving outcomes for patients with acute upper gastrointestinal, and identify opportunities for conservation of blood resources.