Endoscopy 2025; 57(S 02): S50
DOI: 10.1055/s-0045-1805189
Abstracts | ESGE Days 2025
Oral presentation
Management of Upper GI Bleeding: What's Hot? Part 1 03/04/2025, 14:30 – 15:30 Room 122+123

Red pack cell transfusions before or after endoscopy in patients with acute upper gastrointestinal bleeding: a multicentre prospective cohort study

C Marmo
1   Agostino Gemelli University Policlinic, Rome, Italy
,
C Bucci
2   A.O.R.N. Santobono-Pausilipon, Napoli, Italy
,
M Soncini
3   Alessandro Manzoni Hospital, Lecco, Italy
,
M E Riccioni
1   Agostino Gemelli University Policlinic, Rome, Italy
,
R Marmo
4   Presidio ospedaliero Luigi Curto di Polla, Polla, Italy
› Author Affiliations
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Aims The aim of the study is to evaluate the transfusion timing to reduce death risk in patients with upper gastrointestinal bleeding.

Methods This is a prospective multicentre cohort study, including all consecutive hospitalized patients with upper gastrointestinal bleeding (UGIB). Clinical, endoscopic source of bleeding, medical and endoscopic treatment, time to endoscopy, and timing to transfusion were collected. We adopted the ESGE*guidelines to define the need for transfusion, timing to endoscopy and mortality. We considered timing to transfusion before or after the endoscopic procedure. Statistics: multivariate backward logistic regression was used to estimate the adjusted odds ratio death risk for the variables with main clinical relevance or highly statistical significance at univariate analyses [1].

Results 2,017 out of 3324 patients received a transfusion and were included in the analysis; the mean age was 69.7 [±15.1], male was 1,365 (67.7%); the source of bleeding was non-variceal in 1634 patients (81%), 178 patients died (8.8%); 69 out of 700 (9.9%) died in the group transfusion before endoscopy; 109 out 1317 (8.3%) in the group transfusion after endoscopy with an O.R. 1.2 (C.I. 95%.86 to 1.68) p<=0.23. The mortality between two groups did not modify significantly when we considered the haemoglobin value at the admission, neither after adjusting for confounding variable, i.e., ASA score, in-hospital bleeding, haematemesis as presentation, shock at admission, altered mental status. The death risk increased in patients who were transfused before endoscopy with a haemoglobin value>10 gr./l.

Conclusions Red pack cell transfusions before or after endoscopy did not modify the death risk in patients with acute upper gastrointestinal bleeding; the death risk was less frequent numerically in patients with a haemoglobin value from 7 to 8 gr/l; this risk increased in those patients transfused before endoscopy and with a haemoglobin value>10 gr./l.



Publication History

Article published online:
27 March 2025

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