Predictors of Emergency Blood Transfusion in Esophageal Variceal Bleeding

Abstract

Objective: Esophageal variceal bleeding is the most important and common complication of cirrhosis. Predicting the indication of emergency transfusion in patients with esophageal variceal hemorrhage is controversial. The aim of this study is to identify predictors of emergency transfusion by comparing the differences in demographic characteristics, vital signs, complete blood count, biochemistry, Partial thromboplastin time values, use of medication, and the insertion of nasogastric tubes in transfused and non-transfused esophageal variceal bleeding patients. Material and Methods: The files of 51 esophageal variceal bleeding patients admitted to the emergency department between 2000 and 2009 were reviewed retrospectively. Vital signs of the patients, whole blood counts, biochemistry, PTT, INR values, emergency department blood transfusion, medications, and mortalities were recorded. Data were analyzed with SPSS version 17.0. Categorical variables were analyzed with chi-square test, and nonparametric data were analyzed with Mann-Whitney U-test.Results: The incidence of transfusion was significantly higher (p=0.02) in patients with a decreased albumin/globulin ratio. Patients requiring emergency transfusion had significant tachycardia (p=0.016). Age (p=0.026) and hematocrit value (p=0.00001) also predicted the need for emergency transfusion. Conclusion:Low albumin/globulin ratio, tachycardia, and age over 60 in patients with esophageal variceal hemorrhage predict the indication of emergency transfusion. (JAEM 2014; 13: 45-8)