The effect of red‐blood‐cell transfusion on fatigue in hospitalized patients with anaemia

Abstract

Transfusion during hospitalization is associated with reduced fatigue 30 days postdischarge in patients with higher levels of baseline fatigue.

Early and sustained improvement in fatigue-related quality of life following red blood cell transfusion in outpatients

“…[9,4,8] Few studies have measured fatigue in patients for more than a few days after transfusion to examine the time-course of fatigue after RBC transfusion. [5,7] In hospitalized adults, Prochaska et al [5] found that transfusion during an inpatient admission was associated with reduced fatigue at 30 days after discharge. In women with postpartum hemorrhage, subjects randomized to receive RBC transfusion reported less fatigue at 4-6 weeks than women who did not receive transfusions, although the difference was not deemed to be clinically important.…”

“…Fatigue is a well-known symptom of anemia, and low hemoglobin levels are correlated with worse fatigue and poor quality of life in patients with cancer. [1][2][3] Recent studies of hospitalized general medical service patients indicate that red blood cell (RBC) transfusion improves short-term fatigue in inpatients, [4,5] but whether transfusion in the hospital is associated with a sustained, clinically important improvement after hospital discharge is not clear. [6,5,7] Similarly, few studies have examined whether RBC transfusion improves fatigue in outpatient transfusion recipients.…”

“…[1][2][3] Recent studies of hospitalized general medical service patients indicate that red blood cell (RBC) transfusion improves short-term fatigue in inpatients, [4,5] but whether transfusion in the hospital is associated with a sustained, clinically important improvement after hospital discharge is not clear. [6,5,7] Similarly, few studies have examined whether RBC transfusion improves fatigue in outpatient transfusion recipients. [8][9][10] In the outpatient transfusion setting, older patients with diagnoses such as leukemia or myelodysplastic syndrome frequently receive life-sustaining transfusions to maintain hemoglobin levels above a threshold of 7 or 8 g/dL to treat anemia secondary to chemotherapy or bone marrow failure.…”

“…To this end, we used longitudinal models to quantify early (at three days) and sustained (from three days through up to 28 days) change in fatigue following RBC transfusion. To determine whether patients with a greater fatigue burden respond more favorably to transfusion than patients with relatively less fatigue, as has been seen in other clinical settings, [4,5] we employed trajectory modeling to identify such groups. After identifying four groups of patients experiencing distinct levels of fatigue, we further characterized these groups by clinically important patient and transfusion characteristics.…”

Higher executive abilities following a blood transfusion in children and young adults with sickle cell disease

“…From a physiological perspective, we found that improvements in Hb soon after a transfusion were accompanied by greater sustained improvement in executive abilities between transfusions, suggesting that normalizing Hb could improve executive abilities for individuals with SCD. Relatedly, lower Hb is associated with fatigue, which is a commonly reported symptom of SCD that can be improved following a transfusion . Further, fatigue is related to poorer parent‐reported executive function in children with SCD .…”