Figure 1. Therapeutic Misalignments in the Transfusion Requirements in Critical Care (TRICC) Trial ⁸,¹⁰.

Panel A: In the TRICC trial, the treatment effects of the 2 transfusion strategies were significantly different based on the presence of ischemic heart disease (p=0.03).¹⁰ In patients with ischemic heart disease, a restrictive transfusion strategy (n=111) led to increased mortality compared to a liberal transfusion strategy (n=146). In patients without ischemic heart disease, a restrictive transfusion strategy (n=307) led to decreased mortality compared to a liberal transfusion strategy (n=274). Panel B: The odds ratio of survival was significantly lower with a liberal transfusion strategy compared to a restrictive transfusion in the younger (age < 55 years) and healthier patients (APACHE ≤ 20) enrolled in the TRICC trial. (Age < 55 years: restrictive n=173, liberal n=161; Age > 55 years: restrictive n=245, liberal n=259; APACHE < 20: restrictive n=207, liberal n=217; APACHE > 20: restrictive n=211, liberal n=203). These findings suggest that the benefit attributed to a restrictive transfusion strategy may have been due to increased harm secondary to the misalignment of younger and healthier patients enrolled in the trial.

Figure reproduced from Crit Care Med 2007, 35(6):1509-1516.¹⁰