Hemoglobin decrease predicts untoward outcomes better than severity of anemia.

Autor:	Teutsch B; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. teutschbrigitta@gmail.com.; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary. teutschbrigitta@gmail.com.; Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary. teutschbrigitta@gmail.com., Tóth ZA; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary., Ferencz O; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary., Vörhendi N; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary., Simon OA; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary., Boros E; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; First Department of Internal Medicine, Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary., Pálinkás D; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Department of Gastroenterology, Central Hospital of Nothern Pest - Military Hospital, Budapest, Hungary., Frim L; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary., Tari E; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; First Department of Internal Medicine, Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary., Kalló P; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary., Gagyi EB; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Selye János Doctoral College for Advanced Studies, Semmelweis University, Budapest, Hungary., Hussein T; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary., Váncsa S; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary., Vass V; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary., Szentesi A; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary., Vincze Á; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary., Izbéki F; First Department of Internal Medicine, Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary., Hegyi P; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary., Hágendorn R; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary., Szabó I; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary., Erőss B; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary.
Jazyk:	angličtina
Zdroj:	Scientific reports [Sci Rep] 2024 Dec 28; Vol. 14 (1), pp. 31056. Date of Electronic Publication: 2024 Dec 28.
DOI:	10.1038/s41598-024-82237-6
Abstrakt:	Patients with gastrointestinal bleeding (GIB) exhibit varying tolerances to acute blood loss. We aimed to investigate the effect of relative Hb decrease (ΔHb%) on GIB outcomes. Participants enrolled in the Hungarian GIB Registry between 2019 and 2022 were analyzed. The primary outcome, defined as a composite endpoint, included in-hospital bleeding-related mortality and the need for urgent intervention. Four groups were created based on the lowest Hb measured during hospitalization (nadirHb), along with four subgroups categorized by ΔHb%. Regardless of the nadirHb, participants with higher ΔHb% had a higher probability of reaching the composite endpoint. A 30-40% ΔHb% decrease to a nadirHb of 80-90 g/L resulted in a similar likelihood of reaching the primary endpoint as a 0-10% ΔHb% to 70-80 g/L or 60-70 g/L, respectively (10% vs. 12%, p = 1.00; 10% vs. 10%, p = 1.00). Our results showed that a higher Hb decrease in GIB is associated with an increased untoward outcome rate even when the lowest hemoglobin exceeds the recommended transfusion thresholds. New randomized controlled trials investigating transfusion thresholds should consider ΔHb% as a potential key variable and risk factor. Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The data collection in the Hungarian Gastrointestinal Bleeding Registry was approved by the Hungarian Medical Research Council (approval number: 24433-5/2019/EÜIG). (© 2024. The Author(s).)
Databáze:	MEDLINE
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