Aggressive Red Blood Cell Transfusion: No Association with Improved Outcomes for Victims of Isolated Traumatic Brain Injury

Abstract

Our results suggest that a restrictive transfusion practice is safe for severely head-injured patients.

Red Blood Cell Transfusion in Patients With Traumatic Brain Injury: A Systematic Review and Meta-Analysis

“…Three were conducted in Canada; 2, in Taiwan; and others, in China, Columbia, Germany, Switzerland, Tunisia, or United Kingdom. Two studies [35,37] were completed before 1999, year of the publication of the TRICC trial [12]; 19 were conducted after its publication [7,17,[26][27][28][29][30][31]33,34,36,38,39,41,42,45,[47][48][49]; and 2 started before and ended after its publication [32,44]. One study did not report a specific timeframe [43].…”

“…One study did not report a specific timeframe [43]. Seventeen studies [7,17,26,27,29,30,[32][33][34][37][38][39][43][44][45]47,48] had RBC transfusion as an exposure or outcome of interest. Other studies reported data on RBC transfusion for descriptive purposes or as a covariate.…”

“…Other studies reported data on RBC transfusion for descriptive purposes or as a covariate. Five studies [29,32,44,47,48] excluded patients with multiple trauma. All studies were published in English, except 1 in Chinese [48].…”

“…Four studies [7,26,27,38] had selected a sample of patients reflecting a valid estimate (external validity in regard to our question). Twelve studies [7,17,26,32,33,37,39,[41][42][43][44][45] reported information on the way they collected transfusion data that were concordant with a low risk of measurement error. Fifteen studies [7,[26][27][28]32,33,[36][37][38][41][42][43]45,47,48] collected data on RBC transfusion during ICU stay or full hospitalization.…”

“…Twelve studies [7,17,26,32,33,37,39,[41][42][43][44][45] reported information on the way they collected transfusion data that were concordant with a low risk of measurement error. Fifteen studies [7,[26][27][28]32,33,[36][37][38][41][42][43]45,47,48] collected data on RBC transfusion during ICU stay or full hospitalization. Eighteen studies [7,17,[28][29][30][31][32][33][34][35][36][37][38][39]41,45,47,49] reported a proportion of missing data less than 10%.…”