National variation in transfusion strategies in patients with upper gastrointestinal bleeding.

INTRODUCTION: An optimal transfusion strategy for patients with upper gastrointestinal bleeding (UGIB) has yet to be established. The national guidelines contain recommendations for patients with life-threating bleeding in general, but no specific recommendations for patients with UGIB. We hypothesised that there are variations in transfusion strategies for patients with UGIB across the Danish regions.

METHODS: We performed a retrospective, register-based, analysis on transfusions given to all patients with non-variceal UGIB in Denmark in 2011-2013. We compared the results from the five regions in Denmark in order to discover regional differences.

RESULTS: A total of 5,292 admissions with treatment for non-variceal UGIB were identified, and analysis was made for the total group and a massive transfusions group (330 admissions). In the Capital Region, transfusion of platelets was more likely than in any other region for all patients (p < 0.01) including the massive transfusion group (p = 0.03). In the North Region, transfusion of fresh frozen plasma was more likely for the massive transfusion group (p = 0.01).

CONCLUSION: The observed differences warrant further prospective cohort studies in order to provide a foundation for transfusion recommendations for patients with UGIB.

FUNDING: none.

TRIAL REGISTRATION: not relevant.