Evidence map›Paper›PMID 40410779›Full record

SynthesisJournal of orthopaedic surgery and research2025

Restrictive versus Liberal blood transfusion strategies for patients undergoing orthopedic surgery: a meta-analysis of randomised trials with trial sequential analysis.

Zhou Zhou, Zefeng Xiao, Yan Luo, Tuanbiao Nie, Xuelian Xiao

Abstract readMeta-AnalysisComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Zhou Zhou *Department of Neurosurgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, No. 283 Tongzipo Road, Yuelu District, Changsha, Hunan, 410013, China.
Zefeng Xiao *Department of Neurosurgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, No. 283 Tongzipo Road, Yuelu District, Changsha, Hunan, 410013, China.
Yan Luo *Department of Orthopedics, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, Hunan, China.
Tuanbiao NieDepartment of Neurosurgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, No. 283 Tongzipo Road, Yuelu District, Changsha, Hunan, 410013, China. nietuanbiao@hnca.org.cn.
Xuelian XiaoDepartment of Medical Administration, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, No. 283 Tongzipo Road, Yuelu District, Changsha, Hunan, 410013, China. xiaoxuelian@hnca.org.cn.

Funding

Hunan Provincial Health Commission Foundation D202315027975
6 · The paper itself

Abstract

backgroundA meta-analysis was conducted to explore the prognostic differences of restrictive blood transfusion (RBT) versus liberal blood transfusion (LBT) strategies in orthopedic patients.

methodsA comprehensive search was performed in PubMed, Embase, Cochrane Central Register of Controlled Trials, Embase, and clinicaltrials.gov up to 20 October 2024. The quality of included studies was assessed according to Cochrane risk of bias, and quality of evidence was assessed using the GRADE system. We performed sensitivity and publication bias analyses and used trial sequential analysis (TSA) to assess the risk of random error in the analysis results.

results19 studies involving 7833 patients were included in the analysis. Compared with LBT, RBT reduced transfusion rate and increased the occurrence of cardiovascular events (RR = 1.44; 95% CI: 1.15-1.80, P = 0.001; I

conclusionsCompared with LBT, RBT increases the risk of cardiovascular events in orthopedic patients but does not affect adverse outcomes such as infection, thrombotic events, mortality, and delirium.

trial registrationNo patients were involved in this study.

Indexed as

Blood TransfusionOrthopedic ProceduresCardiovascular DiseasesHumansPostoperative ComplicationsRandomized Controlled Trials as TopicBlood transfusionLiberal transfusionMeta-analysisOrthopedic patientsRestrictive transfusionTrial sequential analysis

Identifiers

PMID40410779
PMCPMC12102801

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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.