Does Red Blood Cell Transfusion Increase the Risk for Rebleeding in UGIB?

A large observational study shows a positive association, but prospective trials are needed to address causality.

Acute nonvariceal upper gastrointestinal bleeding (UGIB) is commonly treated with red blood cell (RBC) transfusion. However, recent studies suggest that RBC transfusion is associated with increased risk for adverse patient outcomes in critical care settings. In the current retrospective database study, investigators explored whether RBC transfusion within 24 hours of admission was associated with outcomes of rebleeding or mortality in 1677 patients with acute nonvariceal UGIB who underwent endoscopy in Canadian hospitals.

Overall, 53.7% of patients received RBC transfusions, 17.9% of patients experienced rebleeding, and 5.4% died. After adjusting for multiple confounding variables, RBC transfusion was associated with an increased risk for rebleeding (adjusted odds ratio, 1.8; 95% confidence interval, 1.2–2.8) but was not associated with mortality.

The authors conclude that RBC transfusion is associated with a nearly twofold increased risk for rebleeding.

CITATION(S):

Restellini S et al. Red blood cell transfusion is associated with increased rebleeding in patients with nonvariceal upper gastrointestinal bleeding. Aliment Pharmacol Ther 2012 Dec 3; [e-pub ahead of print].