{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T16:40:12Z","timestamp":1764175212298,"version":"3.40.5"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30 DK123704"],"award-info":[{"award-number":["P30 DK123704"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["P20 GM130457"],"award-info":[{"award-number":["P20 GM130457"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies in upper gastrointestinal (GI) bleeding have reported inconsistent outcomes about packed red blood cell (PRBC) transfusion practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess whether PRBC transfusion is more likely to be dangerous in variceal bleeding than in non\u2010variceal bleeding due to concern of over\u2010transfusion leading to elevated portal pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used the Nationwide Inpatient Sample (1999\u20132018). We identified patients with upper GI bleeding using an algorithmic approach, categorising bleeding from non\u2010variceal or variceal sources. Our primary outcome was all\u2010cause inpatient mortality. To control for the severity of bleeding, we performed propensity matching of baseline features, including age, gender, the presence of shock, the need for ICU care and co\u2010morbidities. We also examined PRBC transfusion, inpatient mortality and hospitalisation rates for both populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 10,228,524 upper GI bleeding discharges; 755,135 patients had variceal bleeding. After propensity matching, PRBC transfusion in variceal bleeders was associated with a 22% increase in inpatient mortality, whereas non\u2010variceal bleeders had a 9% increase in inpatient mortality. Compared to non\u2010variceal bleeders receiving blood transfusion, variceal bleeders had nearly four\u2010fold higher odds of inpatient mortality (propensity\u2010matched OR: 3.8; 95% CI: 3.7\u20133.8; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Notably, PRBC transfusion rates in both groups have declined since 2011, although it has remained higher in variceal bleeders. Mortality for upper GI bleeding has been declining since 1999.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although decreased over the last decade, PRBC transfusion rates remain high for variceal bleeders. In addition, PRBC transfusion appears to be more detrimental in variceal bleeders than in non\u2010variceal bleeders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16965","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T05:25:23Z","timestamp":1653024323000},"page":"41-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The impact of red blood cell transfusion practices on inpatient mortality in variceal and non\u2010variceal gastrointestinal bleeding patients: a 20\u2010year US nationwide retrospective analysis"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6061-7852","authenticated-orcid":false,"given":"Dhruvil","family":"Radadiya","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Motility, Department of Internal Medicine University of Kansas \u2013 School of Medicine  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalpit","family":"Devani","sequence":"additional","affiliation":[{"name":"Prisma Health Gastroenterology &amp; Liver Center  Greenville South Carolina USA"},{"name":"Division of Gastroenterology &amp; Hepatology, Department of Internal Medicine University of South Carolina School of Medicine Greenville Campus  Greenville South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3751-2961","authenticated-orcid":false,"given":"Don C.","family":"Rockey","sequence":"additional","affiliation":[{"name":"Digestive Disease Research Center Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"ZhaoY EncinosaW.Hospitalizations for gastrointestinal bleeding in 1998 and 2006: statistical brief #65. In: Healthcare cost and utilization project (HCUP) statistical briefs. Rockville MD 2006."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4882-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-013-2765-z"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.09.027"},{"issue":"5","key":"e_1_2_8_6_1","first-page":"258","article-title":"Transfusion strategies in acute upper gastrointestinal bleeding","volume":"213","author":"Salgueiro OG","year":"2013","journal-title":"Rev Clin Esp"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61999-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30054-7"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001245"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.228437"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12266"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12771"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jim-2019-001199"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13056"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.36.1.100"},{"volume-title":"Agency for Healthcare Research and Quality","year":"2021","author":"HCUP Databases. 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