Hemoglobin Monitoring in Acute Gastrointestinal Bleeding: Are We Monitoring Blood Counts Too Frequently?
| Autor: | Roula Sasso, Isaac Jaben, Don C. Rockey |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Blood transfusion medicine.medical_treatment Vital signs 030204 cardiovascular system & hematology Article law.invention Hemoglobins 03 medical and health sciences 0302 clinical medicine law Humans Medicine Blood Transfusion Hospital Mortality 030212 general & internal medicine Propensity Score Retrospective Studies business.industry Mortality rate General Medicine Length of Stay Middle Aged medicine.disease Intensive care unit Blood Cell Count Hospitalization Cohort Emergency medicine Female Gastrointestinal Hemorrhage business Packed red blood cells Cohort study |
| Zdroj: | Am J Med |
| Popis: | BACKGROUND: Gastrointestinal hemorrhage is a common cause of hospital admission. However, there are little data to inform practice around blood count monitoring – a cornerstone of management. We hypothesize that more frequent testing leads to increased resource utilization without improvement in patient outcomes. METHODS: This retrospective observational cohort study examined all patients admitted to a large academic medical institution primarily for gastrointestinal bleeding between July 10, 2014 and January 1, 2018. We identified 1150 patients admitted for gastrointestinal hemorrhage. Patients under 18, who developed bleeding while hospitalized, or who were transferred were excluded. The primary outcome was the number of complete blood counts collected in the first 48 hours of admission. Propensity matched analysis was performed to assess blood transfusion, units of blood transfused, time-to-endoscopy, mortality, and 30-day readmission rate. RESULTS: On average, 5.6 complete blood counts were collected in the first 48 hours. 67% of the cohort was transfused (average of 2.6 units of packed red blood cells). When matched for comorbidity, anticoagulant use, location (ward vs. intensive care unit), vital signs, hemoglobin level, and INR, patients having more frequent monitoring had similar hospital length of stay and mortality rates, but were more likely to receive a blood transfusion (0.93 vs. 0.76, p |
| Databáze: | OpenAIRE |
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