ArticleAnnals of intensive care2020
Mortality and morbidity of low-grade red blood cell transfusions in septic patients: a propensity score-matched observational study of a liberal transfusion strategy.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Patient Blood Management (PBM) as a Pillar in Surgical Safety and Care.Revista do Colegio Brasileiro de Cirurgioes · 2026Article
- Hemolysis, hemolytic markers, and mortality in sepsis: a scoping review.Intensive care medicine experimental · 2025Review
- Investigating the feasibility of machine learning to guide personalized red blood cell (RBC) transfusion: analyzing the heterogeneity of RBC transfusion in septic patients with hemoglobin levels of 7-9 g/dL based on the causal forest model.Frontiers in pharmacology · 2025Article
- The treatment of chronic anemia in heart failure: a global approach.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Review
- A nomogram based on serum cystatin C for predicting acute kidney injury in patients with traumatic brain injury.Renal failure · 2021Observational
- [Pathophysiology of bleeding].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021Review
- Effects of red blood cell transfusions given to non-septic critically ill patients: a propensity score matched study.Anaesthesiology intensive therapy · 2021Article
- Beyond hemoglobin thresholds: A physiology-guided framework for red blood cell transfusion in non-bleeding critically ill patients.Science progressReview
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRed blood cell (RBC) transfusions are associated with risks including immunological reactions and volume overload. Current guidelines suggest a restrictive transfusion strategy in most patients with sepsis but based on previous randomized controlled trials and observational studies, there are still uncertainties about the safety in giving low-grade RBC transfusions to patients with sepsis.
methodsCritically ill patients with severe sepsis or septic shock admitted to a university hospital intensive care unit between 2007 and 2018 that received less or equal to 2 units of RBCs during the first 5 days of admission were propensity score matched to controls. Outcomes were 90- and 180-day mortality, highest acute kidney injury network (AKIN) score the first 10 days, days alive and free of organ support the first 28 days after admission to the intensive care unit and highest sequential organ failure assessment score (SOFA-max).
resultsOf 9490 admissions, 1347 were diagnosed with severe sepsis or septic shock. Propensity-score matching resulted in two well-matched groups with 237 patients in each. The annual inclusion rate in both groups was similar. The median hemoglobin level before RBC transfusion was 95 g/L (interquartile range 88-104) and the majority of the patients were transfused in first 2 days of admission. Low-grade RBC transfusion was associated with increased 90- and 180-day mortality with an absolute risk increase for death 9.3% (95% confidence interval: 0.6-18%, P = 0.032) and 11% (95% confidence interval: 1.7-19%, P = 0.018), respectively. Low-grade RBC transfusion also correlated with increased kidney, circulatory and respiratory failure and higher SOFA-max score.
conclusionsLow-grade RBC transfusion during the first 5 days of admission was associated with increased mortality and morbidity in a liberal transfusion setting. The results support the current practice of a restrictive transfusion strategy in septic critically ill patients.
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