Table I.
Randomised controlled studies comparing restrictive versus liberal transfusion triggers in orthopaedic patients.
| Authors (year) | Transfusion trigger | Patients (N) | ABT rate N (%) | ABT volume (U/pte) | Cardiovascular morbidity N (%) | Infection N (%) | Length of stay (days) | 30-day mortality N (%) |
|---|---|---|---|---|---|---|---|---|
| Carson et al. (1998) | L: Hb <10 g/dL | 42 | 41 (98) | 2.0 ± 0.9 | ND | 0 (0.0) | 6.3 ± 3.4 | 1 (2.4) |
| R: signs of acute anaemia or Hb <8g/dL | 42 | 19 (45) | 1.8 ± 1.1 | ND | 1 (2.4) Pneumonia | 6.4 ± 3.4 | 1 (2.4) | |
|
| ||||||||
| Grover et al. (2006) | L: Hb <10 g/dL | 109 | 46 (43) | 0 (0–10) | 2 (1.8) | 5 (4.6) | 7.5 (6–8) | 1 (0.9) |
| R: Hb <8 g/dL | 109 | 37 (34) | 0 (0–5) | 5 (4.6) | 4 (3.7) | 7.3 (7–8) | 0 (0.0) | |
|
| ||||||||
| Foss et al. (2009) | L: Hb <10 g/dL | 60 | 44 (73) | 2 (1–2) | 1 (1.7) | 11 (18.3) | 18 ± 15 | 0 (0) |
| R: Hb <8 g/dL | 60 | 22 (37) | 1 (1–2) | 6 (10.0) | 6 (10.0) | 16 ± 12 | 5 (8) | |
|
| ||||||||
| Carson et al. (2011) | L: Hb <10 g/dL | 1,007 | 970 (96) | 1.9 | 114 (11.3) | 83 (8.2) | USA | 52 (5.2) |
| R: signs of acute anaemia or Hb <8g/dL | 1,009 | 415 (41) | 1.6 | 135 (13.4) | 59 (5.8) | 3.7 ± 3.4 | 43 (4.3) | |
| 4.0 ± 3.9 | ||||||||
| Canada | ||||||||
| 12.0 ± 9.3 | ||||||||
| 12.7 ± 9.5 | ||||||||
|
| ||||||||
| So-Osman et al. (2013) | L: standard practice | 304 | 119 (39.1) | 1.0 ± 1.6 | 27 (8.9) | 31 (10.2) | 10.2 ± 7.4 | 3 (1.0) |
| R: new risk-tailored uniform protocol** | 299 | 79 (26.4) | 0.6 ± 1.4 | 30 (10.0) | 16 (5.4) | 9.6 ± 5.1 | 0 (0) | |
Legend
ABT: allogeneic blood transfusion; Hb: Haemoglobin; L: liberal transfusion protocol; R: restrictive transfusion protocol.
*
Mean ± standard deviation Median (inter-quartile range);
**
See So-Osman et al.26 for details.