Incidence and causes of hyperbilirubinaemia in a hospital population: with particular reference to blood transfusion.

We surveyed a large hospital population of patients to establish the incidence and causes of hyperbilirubinaemia. In a review of 6890 patients, we found an overall incidence of hyperbilirubinaemia of 9%. We reviewed the case histories of 175 patients with hyperbilirubinaemia to analyse the causes and contributory factors. In 22% of patients with hyperbilirubinaemia, hepatobiliary disease was the sole cause and was a contributory cause in another 7%. Disorders of oxygen transport were the single most common cause of hyperbilirubinaemia, being the sole cause in 38% of patients and a contributing cause in a further 9%. Blood transfusion was the sole cause of elevation in bilirubin level in only three patients (1.7%), but was a very significant contributing factor in a further 18%. It is likely that Gilbert's syndrome was a contributing factor in some cases but, as there is no definitive test for diagnosis, clear identification was not possible.