Red blood cell transfusion and outcomes in acute pulmonary embolism

Abstract

RBC transfusion in patients hospitalized with acute PE is rare and appears to be associated with increased risk of short- and long-term mortality, independent of Hb level on admission. This finding underscores the need for future randomized controlled studies on the impact of RBC transfusion in the management of patients admitted with acute PE. [Correction added on 4 May 2018, after first online publication: the word 'serum' was changed to 'plasma' throughout the article where appropriate.].

Red blood cell transfusion in acute pulmonary embolism

“…Second, the variables that were included had Pvalues <0.05 and were mostly recognized predictors of mortality in pulmonary embolism (PE) in previous studies. [1][2][3] The incorporation of various haemodynamic parameters (heart rate, blood pressure etc.) into a single variable (simplified PE severity index (sPESI)-a well-validated prognostic score in PE) was specified a priori to avoid overfitting the multivariable model.…”

“…Wong et al . reported that in patients with acute pulmonary embolism (APE), red blood cell (RBC) transfusion is associated with higher mortality, independent of haemoglobin level.…”

Red cell transfusion and clinical outcomes in acute pulmonary embolism: Harmful therapy or an indicator of sicker patients with poor prognosis?

“…It also carries risks of adverse effects and major costs.In a recent publication in Respirology, Wong et al present a single-centre retrospective analysis of the effect of RBC transfusion and mortality on patients hospitalized between 2000 and 2012 with a primary diagnosis of acute pulmonary embolism (PE). 1 They report increased 30-day and 6-month mortality of 19% and 40%, respectively, in 73 (5%) transfused patients, compared with 4% and 10% in the 1303 nontransfused patients. This was reported as an odds ratio for mortality of 3.06 (95% CI: 1.17-8.01) at 30 days and a hazard ratio of 1.97 (95% CI: 1.12-3.46) at 6 months.…”

“…In a recent publication in Respirology, Wong et al . present a single‐centre retrospective analysis of the effect of RBC transfusion and mortality on patients hospitalized between 2000 and 2012 with a primary diagnosis of acute pulmonary embolism (PE) …”

Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study

“…However, recent conflicting evidence suggests that a single measure of baseline haemoglobin on admission for acute PE may not be predictive of mortality after taking into account the impact of blood transfusions 4. Haemoglobin fluctuations and variability have been explored in other diseases, such as chronic heart failure, end-stage renal failure and malignancy; these studies showed that persistent anaemia or declining haemoglobin trends were associated with poorer outcomes 5–12.…”