Factors Associated with Transfusion of Uncross-matched Type-O Packed Red Cells for Acute Upper Gastrointestinal Hemorrhage
Ienghong K, MD1, Srikumpa P, MD1, Apiratwarakul K, MD1, Phungoen P, MD1, Gaysonsiri D, MD2, Bhudhisawasdi V, MD1
Affiliation : 1 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Acute upper gastrointestinal hemorrhage is a life-threatening condition that necessitates treatment within the first
hour at the emergency department. Although prompt blood transfusion is one resuscitation procedure that can be implemented in
these cases, its indications are not well understood.
Objective : To study factors that affect transfusion of uncross-matched type-O pack red cells (UOPRC) in acute upper gastrointestinal
hemorrhage at the emergency department of a tertiary university hospital.
Materials and Methods: This was a cross-sectional analytical study. The population was acute upper gastrointestinal bleeding
patients at the Srinagarind Hospital emergency department (Khon Kaen University Faculty of Medicine) from August 1, 2016 to
August 31, 2019. Data were collected by reviewing Health Object program (Hospital data) and Medical charts. Multiple Logistic
regression analysis was performed to determine which factors were associated with transfusion of UOPRC and to study the
mortality rate in these patients.
Results : The three risk factors found in the UOPRC group were heart rate >100 bpm (OR 4.60, p<0.05, 95% CI 1.794, 12.126), shock
index >0.8 (OR 3.78, p<0.05, 95% CI 1.464, 10.706), and history of blood transfusion (OR 2.96, p<0.05, 95% CI 1.126, 7.723). The
mortality rate was 29% in the UOPRC group and 1.1% in the non-UOPRC group.
Conclusion : Heart rate >100 bpm was the main factor associated with transfusion of UOPRC in acute upper gastrointestinal
hemorrhage patients at the Srinagarind Hospital emergency department. Further research should be conducted based on the results
from the present study to establish emergency blood transfusion criteria.
Keywords : Blood transfusion, Gastrointestinal hemorrhage, Emergency department, Tertiary hospital
