Evidence map›Paper›PMID 27775503›Full record

Trial reportThe New England journal of medicine2016

Effect of Short-Term vs. Long-Term Blood Storage on Mortality after Transfusion.

Nancy M Heddle, Richard J Cook, Donald M Arnold, Yang Liu, Rebecca Barty, Mark A Crowther, P J Devereaux, Jack Hirsh, Theodore E Warkentin, Kathryn E Webert and 7 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06840756 (Effects of Donor-recipient Sex-matched Versus Sex-mismatched Red Blood Cell Transfusion on Outcomes in Critically Ill Adult Patients), which is not on this map. Cited by 120 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06840756 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Effects of Donor-recipient Sex-matched Versus Sex-mismatched Red Blood Cell Transfusion on Outcomes in Critically Ill Adult Patients

TypeinterventionalSponsorMichelle ZellerRan2025 to 2029Enrolled11,082ConditionsRed Blood Cell Transfusions, Sex Differences, Health Services, Critically Ill Intensive Care Unit PatientsArmsSex-mismatched red blood cell transfusions, Sex-matched red blood cell transfusions
3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
  2. Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024
    Pooled it
  3. Prophylactic Transfusion Strategies in Children Supported by Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2024
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  17. Analysis of the Efficacy of Red Blood Cell Transfusion in Very Low Birth Weight Infants and Construction of a Prediction Model.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2026
    Article
  18. Review
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60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Nancy M HeddleFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Richard J CookFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Donald M ArnoldFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Yang LiuFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Rebecca BartyFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Mark A CrowtherFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
P J DevereauxFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Jack HirshFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Theodore E WarkentinFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Kathryn E WebertFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
David RoxbyFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Magdalena Sobieraj-TeagueFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Andrea KurzFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Daniel I SesslerFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Priscilla FigueroaFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
Martin EllisFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).
John W EikelboomFrom the Departments of Medicine (N.M.H., D.M.A., Y.L., R.B., M.A.C., P.J.D., J.H., T.E.W., J.W.E.), Pathology and Molecular Medicine (N.M.H., M.A.C., T.E.W., K.E.W.), and Clinical Epidemiology and Biostatistics (N.M.H., P.J.D.) and McMaster Centre for Transfusion Research (N.M.H., R.J.C., D.M.A., Y.L., R.B., T.E.W., K.E.W.), McMaster University, Canadian Blood Services (N.M.H., D.M.A., K.E.W.), the Population Health Research Institute (P.J.D., J.W.E.), and the Thrombosis and Atherosclerosis Research Institute (J.W.E.), Hamilton, ON, and the Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON (R.J.C.) - all in Canada; SA Pathology Transfusion Service, Flinders Medical Centre and Flinders University, Adelaide, SA, Australia (D.R., M.S.-T.); the Departments of General Anesthesiology (A.K.) and Outcomes Research (A.K., D.I.S.), Anesthesiology Institute, and the Robert J. Tomsich Pathology and Laboratory Medicine Institute and the Department of Laboratory Medicine (P.F.), Cleveland Clinic, Cleveland; and Meir Medical Center Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (M.E.).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRandomized, controlled trials have suggested that the transfusion of blood after prolonged storage does not increase the risk of adverse outcomes among patients, although most of these trials were restricted to high-risk populations and were not powered to detect small but clinically important differences in mortality. We sought to find out whether the duration of blood storage would have an effect on mortality after transfusion in a general population of hospitalized patients.

methodsIn this pragmatic, randomized, controlled trial conducted at six hospitals in four countries, we randomly assigned patients who required a red-cell transfusion to receive blood that had been stored for the shortest duration (short-term storage group) or the longest duration (long-term storage group) in a 1:2 ratio. Only patients with type A or O blood were included in the primary analysis, since pilot data suggested that our goal of achieving a difference in the mean duration of blood storage of at least 10 days would not be possible with other blood types. Written informed consent was waived because all the patients received treatment consistent with the current standard of care. The primary outcome was in-hospital mortality, which was estimated by means of a logistic-regression model after adjustment for study center and patient blood type.

resultsFrom April 2012 through October 2015, a total of 31,497 patients underwent randomization. Of these patients, 6761 who did not meet all the enrollment criteria were excluded after randomization. The primary analysis included 20,858 patients with type A or O blood. Of these patients, 6936 were assigned to the short-term storage group and 13,922 to the long-term storage group. The mean storage duration was 13.0 days in the short-term storage group and 23.6 days in the long-term storage group. There were 634 deaths (9.1%) in the short-term storage group and 1213 (8.7%) in the long-term storage group (odds ratio, 1.05; 95% confidence interval [CI], 0.95 to 1.16; P=0.34). When the analysis was expanded to include the 24,736 patients with any blood type, the results were similar, with rates of death of 9.1% and 8.8%, respectively (odds ratio, 1.04; 95% CI, 0.95 to 1.14; P=0.38). Additional results were consistent in three prespecified high-risk subgroups (patients undergoing cardiovascular surgery, those admitted to intensive care, and those with cancer).

conclusionsAmong patients in a general hospital population, there was no significant difference in the rate of death among those who underwent transfusion with the freshest available blood and those who underwent transfusion according to the standard practice of transfusing the oldest available blood. (Funded by the Canadian Institutes of Health Research and others; INFORM Current Controlled Trials number, ISRCTN08118744 .).

Indexed as

Blood PreservationHospital MortalityAdultAgedBlood TransfusionFemaleHospitalizationHumansLogistic ModelsMaleMiddle AgedTime Factors

Identifiers

PMID27775503

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.