Z Gastroenterol 2019; 57(05): e148
DOI: 10.1055/s-0039-1691900
POSTER
Gastroenterologie
Georg Thieme Verlag KG Stuttgart · New York

Prospective evaluation of blood transfusion management in patients with gastrointestinal bleedings at the University Hospital St. Pölten

M Stättermayer
1   Klinische Abteilung für Innere Medizin 2, Universitätsklinikum St. Pölten, St. Pölten, Austria
,
F Riedl
1   Klinische Abteilung für Innere Medizin 2, Universitätsklinikum St. Pölten, St. Pölten, Austria
,
S Bernhofer
1   Klinische Abteilung für Innere Medizin 2, Universitätsklinikum St. Pölten, St. Pölten, Austria
,
A Stättermayer
2   Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Medizinische Universität Wien, Wien, Austria
,
A Mayer
1   Klinische Abteilung für Innere Medizin 2, Universitätsklinikum St. Pölten, St. Pölten, Austria
,
A Maieron
1   Klinische Abteilung für Innere Medizin 2, Universitätsklinikum St. Pölten, St. Pölten, Austria
3   Arbeitsgruppe Qualitätssicherung der Österreichischen Gesellschaft für Gastroenterologie und Hepatologie (ÖGGH), Wien, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2019 (online)

Also available at
 

Introduction:

Gastrointestinal (GI) bleedings are a common cause for hospital admission and are often a life-threatening situation which may need the administration of erythrocyte concentrates (EC). Current guidelines recommend the substitution of EC at a hemoglobin < 7.0 g/dL for patients without cardiovascular diseases (CVD). In patients with CVD a higher baseline is tolerated. As part of a prospective registrya major aspect is the evaluation of quality factors and the fault finding. This gives a chance to develop strategies to find mistakes and to strive for improvements.

Methods:

All patients over the age of 18 years, who present with melena, hematochezia, hematemesis, or positive fecal occult blood test (FOBT) and who have been excluded from variceal bleeding were included into the registry after giving a declaration of informed consent. If necessary, the clarification was done by means of gastroscopy, colonoscopy or further diagnostic procedures (e.g. capsule endoscopy).

Results:

At the time of submission, a total of 580 patients were enrolled and up to now data of 328 patients were analyzed, of whom 322 (98.2%) underwent endoscopic examination. The majority was male (n = 196 [59.8%]); the mean age was 70.3 (CI95% 68.5 – 72.1, [range: 19.1 – 96.4]) years. Mean hemoglobin nadir was 8.9 g/dL (CI95%: 8.6 – 9.1 g/dL). Twenty-three individuals (7.0%) died within the observation period, and in six (1.8%) patients' death was directly related to GI bleeding. Blood transfusions were administered in 154 patients (47.0%), of whom 79 patients (51.3%) had a hemoglobin nadir > 7.0 g/dL. Nevertheless, 43 (54.4%) of them had a CVD. None of the deceased was transfused incorrectly.

Conclusion:

Non-variceal GI bleeding is a common cause for hospital admission and often lead to the necessity of blood transfusions. Nevertheless, in many cases transfusion policy should be critically questioned as the patients' outcome may be declined.