| TEG or ROTEM compared to SLT‐guided transfusion in adults or children with bleeding |
|
Patient or population: adults or children with bleeding
Setting: The majority of participants were undergoing cardiac surgery involving cardiopulmonary bypass in a high‐income hospital setting
Intervention: TEG or ROTEM
Comparison: SLT‐guided transfusion |
| Outcomes |
Anticipated absolute effects* (95% CI) |
Relative effect
(95% CI) |
№ of participants
(studies) |
Quality of the evidence
(GRADE) |
Comments |
| Risk with SLT‐guided transfusion |
Risk with TEG or ROTEM |
| Mortality |
Study population |
RR 0.36
(0.16 to 0.84) |
272
(4 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 129 per 1000 |
46 per 1000
(21 to 108) |
| |
| Proportion of patients receiving PRBCs |
Study population |
RR 0.91
(0.83 to 1.00) |
244
(3 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 932 per 1000 |
848 per 1000
(774 to 932) |
| |
| Proportion of patients receiving FFP |
Study population |
RR 0.83
(0.49 to 1.40) |
346
(4 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 538 per 1000 |
447 per 1000
(264 to 754) |
| |
| Proportion of patients receiving platelets |
Study population |
RR 0.87
(0.68 to 1.11) |
244
(3 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 551 per 1000 |
479 per 1000
(375 to 611) |
| |
| Rate of surgical reintervention |
Study population |
RR 0.82
(0.46 to 1.46) |
248
(3 studies) |
⊕⊕⊝⊝
low
|
Quality of the evidence (GRADE) adjusted due to high risk of bias and imprecision. |
| 217 per 1000 |
178 per 1000
(100 to 316) |
| |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; FFP: fresh frozen plasma; PRBC: pooled red blood cell; ROTEM: thromboelastometry; RR: risk ratio; SLT: standard laboratory test; TEG: thromboelastography. |
|
GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. |
