Evaluation of the impact of hemotransfusion on hospitalization length and complications in patients with non-variceal upper gastrointestinal bleeding

Abstract

Background: Upper gastrointestinal bleeding (UGB) is a common emergency associated with high morbidity and mortality. It can be caused by various factors, including peptic ulcers and vascular lesions. The decision to perform blood transfusion in stable UGB patients is still controversial, with more restrictive strategies showing better outcomes. Methods: A retrospective cohort study reviewed 1433 medical records of non-variceal UGB patients in a Brazilian tertiary care setting. Patients were divided into groups based on whether they received blood transfusion or not. Patient characteristics, laboratory values, procedures, and outcomes were analyzed. Logistic and linear regression models were used to assess the association of blood transfusion with complications and hospital stay. Results: Blood transfusion was associated with increased hospitalization length (p<0.001), higher rebleeding rates (p<0.001), and greater clinical severity. However, no association with worse renal outcomes was observed (p=0.203). Adjusting for clinical severity (Glasgow-Blatchford score) reduced the significance of the association with hospitalization length. Conclusion: Blood transfusion in stable UGB patients may serve as a marker of severity, associated with longer hospital stay and increased rebleeding rates. It does not appear to have a direct causal relationship with worse renal outcomes. The study suggests that clinical severity may play a pivotal role in outcomes, as indicated by the association with Glasgow-Blatchford score.