In:
Transfusion Medicine and Hemotherapy, S. Karger AG, Vol. 45, No. 5 ( 2018), p. 355-367
Abstract:
〈 b 〉 Background: 〈 /b 〉 Benefits and risks of liberal and restrictive transfusion regimens are under on-going controversial discussion. This systematic review aimed at assessing both regimens in terms of pre-defined outcomes with special focus on patients undergoing major orthopaedic surgery. 〈 b 〉 Methods: 〈 /b 〉 We performed a literature search for mortality, morbidity and related outcomes following peri-operative blood transfusion in patients with major orthopaedic surgery in electronic databases. Combined outcome measure estimates were calculated within the scope of meta-analyses including randomised clinical trials comparing restrictive versus liberal blood transfusion regimens (e.g. MH risk ratio, Peto odds ratio). 〈 b 〉 Results: 〈 /b 〉 A total of 880 publications were identified 15 of which were finally included (8 randomised clinical trials (RCTs) with 3,693 patients and 6 observational studies with 4,244,112 patients). Regarding RCTs, no significant differences were detected between the transfusion regimes for all primary outcomes (30-day mortality, thromboembolic events, stroke/transitory ischaemic attack, myocardial infarction, wound infection and pneumonia) and a secondary outcome (length of hospital stay), whereas there was a significantly reduced risk of receiving at least one red blood concentrate under a restrictive regimen. 〈 b 〉 Conclusion: 〈 /b 〉 The results of this systematic review do not suggest an increased risk associated with either a restrictive or a liberal transfusion regimen in patients undergoing major orthopaedic surgery.
Type of Medium:
Online Resource
ISSN:
1660-3796
,
1660-3818
Language:
English
Publisher:
S. Karger AG
Publication Date:
2018
detail.hit.zdb_id:
2100533-3
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