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Müller S, Oberle D, Drechsel-Bäuerle U, et al. Mortality, Morbidity and Related Outcomes Following Perioperative Blood Transfusion in Patients with Major Orthopaedic Surgery: A Systematic Review. Transfus Med Hemother. 2018;45(5):355-367doi: 10.1159/000481994.
Müller, S., Oberle, D., Drechsel-Bäuerle, U., Pavel, J., Keller-Stanislawski, B., & Funk, M. B. (2018). Mortality, Morbidity and Related Outcomes Following Perioperative Blood Transfusion in Patients with Major Orthopaedic Surgery: A Systematic Review. Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie, 45(5), 355-367. https://doi.org/10.1159/000481994
Müller, Susanne, et al. "Mortality, Morbidity and Related Outcomes Following Perioperative Blood Transfusion in Patients with Major Orthopaedic Surgery: A Systematic Review." Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie vol. 45,5 (2018): 355-367. doi: https://doi.org/10.1159/000481994
Müller S, Oberle D, Drechsel-Bäuerle U, Pavel J, Keller-Stanislawski B, Funk MB. Mortality, Morbidity and Related Outcomes Following Perioperative Blood Transfusion in Patients with Major Orthopaedic Surgery: A Systematic Review. Transfus Med Hemother. 2018 Oct;45(5):355-367. doi: 10.1159/000481994. Epub 2018 Feb 28. PMID: 30498414; PMCID: PMC6257151.
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Transfus Med Hemother. 2018 Oct;45(5):355-367. doi: 10.1159/000481994. Epub 2018 Feb 28.

Mortality, Morbidity and Related Outcomes Following Perioperative Blood Transfusion in Patients with Major Orthopaedic Surgery: A Systematic Review.

Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie

Susanne Müller, Doris Oberle, Ursula Drechsel-Bäuerle, Jutta Pavel, Brigitte Keller-Stanislawski, Markus B Funk

Affiliations

  1. Division Safety of Medicinal Products and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany.

PMID: 30498414 PMCID: PMC6257151 DOI: 10.1159/000481994

Abstract

BACKGROUND: 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.

METHODS: 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).

RESULTS: 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.

CONCLUSION: 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.

Keywords: Erythrocyte transfusion; Haemovigilance; Immunomodulation; Meta-analyses; Non-haemolytic transfusion reactions; Peri-operative period; Restrictive and liberal transfusion regimes; Systematic review

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