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.