21. Overview of results: Orthopaedic (hip).
| Outcome |
Total [95% CI] |
Subgroup: blood salvage (collection time) | Subgroup: transfusion threshold | ||||
| Intraoperative | Postoperative | Both | No transfusion threshold | Liberal threshold (Hb > 80 g/L) | Restrictive threshold (Hb ≦ 80 g/L) | ||
| Risk of transfusion |
RR 0.52 [0.38, 0.72] 14 RCTs, N = 1641 ⨁◯◯◯ |
RR 0.60 [0.40, 0.89] 2 RCTs, N = 65 ⨁⨁◯◯ |
RR 0.44 [0.26, 0.76] 9 RCTs, N = 1168 ⨁◯◯◯ |
RR 0.67 [0.41, 1.11] 4 RCTs, N = 408 ⨁⨁◯◯ |
RR 0.76 [0.37, 1.57] 4 RCTs, N = 585 ⨁◯◯◯ |
RR 0.50 [0.28, 0.90] 4 RCTs, N = 156 ⨁◯◯◯ |
RR 0.38 [0.28, 0.51] 6 RCTs, N = 900 ⨁⨁⨁◯ |
| Volume transfused (PPR) |
MD ‐0.61 [‐1.04, ‐0.19] 5 RCTs, N = 433 ⨁◯◯◯ |
MD ‐1.03 [‐1.61, ‐0.45] 2 RCTs, N = 69 ⨁⨁◯◯ |
MD ‐0.78 [‐2.19, 0.63] 1 RCTs, N = 160 ⨁◯◯◯ |
MD ‐0.10 [‐0.23, 0.03] 1 RCT, N = 204 ⨁⨁⨁◯ |
MD ‐1.29 [‐1.69, ‐0.90] 3 RCTs, N = 129 ⨁⨁⨁◯ |
MD ‐0.09 [‐0.20, 0.02] 2 RCTs, N = 304 ⨁⨁⨁◯ |
|
| Volume transfused (PPT) |
MD ‐1.74 [‐2.92, ‐0.55] 4 RCTs, N = 63 ⨁◯◯◯ |
MD ‐2.04 [‐2.92, ‐1.16] 1 RCT, N = 16 ⨁◯◯◯ |
MD ‐0.53 [‐2.98, 1.92] 2 RCTs, N = 34 ⨁◯◯◯ |
Not estimable (SD 0 in both groups) 1 RCT, N = 13 ⨁◯◯◯ |
MD ‐1.74 [‐2.92, ‐0.55] 2 RCTs, N = 44 ⨁⨁◯◯ |
Not estimable (SD zero in both groups) 2 RCTs, N = 19 ⨁◯◯◯ |
|
| All‐cause mortality | POR 0.46 [0.06, 3.33] 4 RCTs, N = 651 ⨁◯◯◯ |
POR 0.19 [0.01, 3.20] 2 RCTs, N = 317 ⨁◯◯◯ |
POR 1.07 [0.07, 17.17] 2 RCTs, N = 334 ⨁◯◯◯ |
POR 0.19 [0.01, 3.20] 2 RCTs, N = 317 ⨁◯◯◯ |
POR 0.14 [0.00, 7.08] 1 RCT, N = 216 ⨁◯◯◯ |
POR 8.22 [0.16, 416.61] 1 RCT, N = 118 ⨁◯◯◯ |
|
| Blood loss | MD ‐78.13 [‐162.74, 6.48] 10 RCTs, N = 1085 ⨁◯◯◯ |
MD ‐260.64 [‐1209.11, 687.83] 2 RCTs, N = 65 ⨁◯◯◯ |
MD ‐12.52 [‐27.17, 2.13] 4 RCTs, N = 451 ⨁⨁◯◯ |
MD ‐111.32 [‐238.53, 15.89] 4 RCTs, N = 569 ⨁⨁⨁◯ |
MD 3.00 [‐86.67, 92.67] 1 RCT, N = 91 ⨁⨁◯◯ |
MD ‐86.79 [‐354.95, 181.36] 5 RCTs, N = 372 ⨁◯◯◯ |
MD ‐115.60 [‐240.14, 8.95] 4 RCTs, N = 622 ⨁⨁◯◯ |
| Re‐operation | RD 0.00 [‐0.03, 0.03] 1 RCT, N = 153 ⨁◯◯◯ |
RD 0.00 [‐0.03, 0.03] 1 RCT, N = 153 ⨁◯◯◯ |
RD 0.00 [‐0.03, 0.03] 1 RCT, N = 153 ⨁◯◯◯ |
||||
| Infection | POR 0.72 [0.17, 2.98] 4 RCTs, N = 549 ⨁◯◯◯ |
POR 0.55 [0.12, 2.52] 4 RCTs, N = 494 ⨁◯◯◯ |
POR 4.81 [0.08, 283.10] 1 RCT, N = 55 ⨁◯◯◯ |
POR 0.72 [0.17, 2.98] 3 RCTs, N = 429 ⨁◯◯◯ |
Not estimable (zero cases) 1 RCT, N = 120 ⨁◯◯◯ |
||
| Wound complication | POR 0.94 [0.36, 2.45] 4 RCTs, N = 609 ⨁◯◯◯ |
POR 1.18 [0.38, 3.65] 3 RCTs, N = 338 ⨁◯◯◯ |
POR 0.54 [0.09, 3.22] 2 RCTs, N = 271 ⨁◯◯◯ |
POR 1.94 [0.30, 12.58] 1 RCT, N = 115 ⨁◯◯◯ |
POR 0.53 [0.05, 5.15] 1 RCT, N = 216 ⨁◯◯◯ |
POR 0.80 [0.22, 2.89] 2 RCTs, N = 278 ⨁◯◯◯ |
|
| PJI | POR 0.31 [0.05, 1.78] 5 RCTs, N = 806 ⨁◯◯◯ |
Not estimable (zero cases) 2 RCTs, N = 213 ⨁◯◯◯ |
POR 0.31 [0.05, 1.78] 4 RCTs, N = 593 ⨁◯◯◯ |
Not estimable (zero cases) 2 RCTs, N = 268 ⨁◯◯◯ |
POR 0.14 [0.00, 7.08] 1 RCT, N = 216 ⨁◯◯◯ |
POR 0.37 [0.05, 2.68] 2 RCTs, N = 322 ⨁◯◯◯ |
|
| VTE/thrombosis | POR 1.45 [0.24, 8.72] 2 RCTs, N = 196 ⨁◯◯◯ |
POR 1.45 [0.24, 8.72] 2 RCTs, N = 196 ⨁◯◯◯ |
POR 1.45 [0.24, 8.72] 1 RCT, N = 96 ⨁◯◯◯ |
Not estimable (zero cases) 1 RCT, N = 100 ⨁◯◯◯ |
|||
| DVT | POR 1.05 [0.20, 5.60] 3 RCTs, N = 343 ⨁◯◯◯ |
POR 1.66 [0.26, 10.58] 1 RCT, N = 39 ⨁◯◯◯ |
Not estimable (zero cases) 1 RCT, N = 100 ⨁⨁◯◯ |
POR 0.14 [0.00, 6.82] 1 RCT, N = 204 ⨁◯◯◯ |
POR 1.66 [0.26, 10.58] 1 RCT, n = 39 ⨁◯◯◯ |
POR 0.14 [0.00, 6.82] 2 RCTs, N = 304 ⨁◯◯◯ |
|
| PE | POR 0.14 [0.00, 7.08] 2 RCTs, N = 316 ⨁◯◯◯ |
Not estimable (zero cases) 1 RCT, N = 100 ⨁⨁◯◯ |
POR 0.14 [0.00, 7.08] 1 RCT, N = 216 ⨁◯◯◯ |
POR 0.14 [0.00, 7.08] 1 RCT, N = 216 ⨁◯◯◯ |
Not estimable (zero cases) 1 RCT, N = 100 ⨁◯◯◯ |
||
| MACE | |||||||
| MI | |||||||
| CVA/stroke | RR 3.00 [0.13, 68.26] 1 RCT, N = 30 ⨁◯◯◯ |
RR 3.00 [0.13, 68.26] 1 RCT, N = 30 ⨁◯◯◯ |
RR 3.00 [0.13, 68.26] 1 RCT, N = 30 ⨁◯◯◯ |
||||
| Hospital LOS | MD 0.07 [‐0.37, 0.52] 4 RCTs, N = 542 ⨁◯◯◯ |
MD 0.19 [‐0.79, 1.17] 2 RCTs, N = 220 ⨁◯◯◯ |
MD ‐0.01 [‐0.50, 0.47] 2 RCTs, N = 322 ⨁⨁◯◯ |
MD 0.07 [‐0.37, 0.52] 4 RCTs, N = 542 ⨁◯◯◯ |
|||
One study reporting orthopaedic (hip) reported data for more than one collection period, and so appears in more than one subgroup for timing: Rollo 1995 (postoperative only and both).
Bolded data highlights where there was a clear intervention effect.
"Volume" refers to mean transfusion volume; "transfusions" refers to number of people receiving an allogeneic transfusion
CI: confidence interval; CVA: cerebrovascular accident; DVT: deep vein thrombosis; Hb: haemoglobin; LOS: hospital length of stay; MACE: major adverse cardiovascular events; MD: mean difference; MI: myocardial infarction; N: number of people analysed; PE: pulmonary embolism; PJI: prosthetic joint infection; POR: Peto odds ratio; PPR: per person randomised; PPT: per person transfused; RCT: randomised controlled trial; RD: risk difference; RR: risk ratio; VTE: venous thromboembolism
⨁◯◯◯ = Very low certainty; ⨁⨁◯◯ = Low certainty; ⨁⨁⨁◯ = Moderate certainty; ⨁⨁⨁⨁ = High certainty