title: The influence of a simple blood transfusion policy on overtransfusion in acute upper gastrointestinal haemorrhage.
abstract: Blood transfusion is widely used in the management of acute upper gastrointestinal haemorrhage (AUGIH). Trial data suggests that excessive transfusion may be detrimental, yet overtransfusion remains commonplace. This study reports the impact of introducing a simple cross-match policy in a district general hospital, which resulted in a substantial fall in the prevalence of overtransfusion (odds ratio 0.43; 95% confidence interval 0.19-0.98), with potential patient benefits in terms of rebleeding, and a reduction in the total blood transfused from 162 to 121 units per 100 patients with AUGIH. For the cost of blood alone, this corresponds to projected savings across the NHS in England in excess of £2 million per annum.
authors.affiliation: Poole Hospital NHS Foundation Trust, Poole, UK;
authors.forename: Adam
authors.initials: A
authors.lastname: Stokes
authors.affiliation: Poole Hospital NHS Foundation Trust, Poole, UK;
authors.forename: Clare
authors.initials: C
authors.lastname: Thompson
authors.affiliation: University of Southampton, Southampton, UK;
authors.forename: Andrew
authors.initials: A
authors.lastname: Clegg
authors.affiliation: Poole Hospital NHS Foundation Trust, Poole, UK jonathon.snook@poole.nhs.uk.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Snook
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D004739:England / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000628:therapy*; D006767:Hospitals, District / Q000331:legislation & jurisprudence*; D006801:Humans; D015994:Incidence; D007857:Leadership; D008297:Male; D011050:Policy Making; D012189:Retrospective Studies; D013222:State Medicine
keywords: Acute upper gastrointestinal haemorrhage; blood transfusion; overtransfusion