Evidence map›Paper›PMID 26675926›Full record

ArticleWorld journal of surgery2016

Effect of Transfusion Strategy in Acute Non-variceal Upper Gastrointestinal Bleeding: A Nationwide Study of 5861 Hospital Admissions in Denmark.

Rasmus Fabricius, Peter Svenningsen, Jens Hillingsø, Lars Bo Svendsen, Martin Sillesen

Abstract read
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In one paragraph

Article in World journal of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. [Guidelines for Non-variceal Upper Gastrointestinal Bleeding].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2020
    Guideline
  2. Article
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  4. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rasmus FabriciusDepartment of Surgery, Copenhagen University Hospital, Hillerød, Denmark.
Peter SvenningsenDepartment of Surgical Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Jens HillingsøDepartment of Surgical Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Lars Bo SvendsenDepartment of Surgical Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Martin SillesenDepartment of Surgical Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. martin.sillesen@regionh.dk.ORCID http://orcid.org/0000-0001-9494-5475

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute non-variceal upper gastrointestinal bleeding (NVUGIB) is a common cause of admissions as well as aggressive transfusion of blood products. Whether the transfusion strategy in NVUGIB impacts on hemostasis is unknown and constitutes the focus of this study.

methodRetrospective analysis of all hospital admissions in Denmark between 2011 and 2013 where hemostatic endoscopic interventions in either the stomach or duodenum had been employed. Regression modeling was used to predict the effect of units transfused of packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelets (PLT) on primary outcome 30-day mortality as well as secondary hemostasis-related outcomes and need for re-endoscopy and conversion to surgery. The model was corrected for confounders, including transfusion of other blood products (PRBC, FFP, and PLT, respectively), patient age as well as pre-existing medical conditions.

results5107 patients received 10783 therapeutic endoscopic interventions. Units of PRBC transfused were identified as a predictor of re-endoscopy, surgery, and 30-day mortality with odds ratio (OR) 1.08 (1.06-1.09, p < 0.01), 1.05 (1.03-1.07, p < 0.01), and 1.04 (1.01-1.06, p < 0.01), respectively. Units of FFP transfused were associated with a higher risk of surgery and 30-day mortality with OR 1.05 (1.02-1.08, p < 0.01) and 1.04 (1.02-1.07, p < 0.01), respectively. Units of PLTs transfused were independently associated with a reduction in risk of re-endoscopy 0.93 (0.87-0.98, p = 0.02). A high ratio of PRBC:FFP:PLT (1:1:1) was associated with reduced need for re-endoscopy OR 0.23 (0.06-0.67, p = 0.01) but increased mortality with OR 3.60 (1.34-11.38, p = 0.02).

conclusionPRBC transfusion was associated with adverse events, including 30-day mortality and failure of hemostasis. In contrast, transfusion of PLT was associated with a reduction in need for re-endoscopy.

Indexed as

Blood TransfusionHospitalizationPlasmaAgedAged, 80 and overDenmarkEndoscopy, GastrointestinalFemaleGastrointestinal HemorrhageHemostasis, EndoscopicHumansMaleMiddle AgedModels, StatisticalRegistriesRegression Analysis

Identifiers

PMID26675926

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.