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Liberal or Restrictive Transfusion in High-Risk Patients after Hip Surgery
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Liberal or Restrictive Transfusion in High-Risk Patients after Hip Surgery
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Journal Article
Liberal or Restrictive Transfusion in High-Risk Patients after Hip Surgery
2011
Overview
This trial compared a restrictive hemoglobin threshold with a liberal threshold for blood transfusion among hip-surgery patients with risk factors for CVD. The liberal strategy resulted in more transfusions and did not reduce death or inability to walk independently.
In the United States, more than 17 million red-cell units are collected annually, and 15 million units are transfused.
1
Blood transfusions are frequently given to surgical patients and to the elderly.
2
,
3
Yet, the indications for postoperative transfusion have not been adequately evaluated and remain controversial. Most clinical trials have been small.
4
One adequately powered trial involving adults in intensive care units showed a nonsignificant decrease in 30-day mortality with a restrictive transfusion strategy, as compared with a liberal strategy (18.7% vs. 23.3%).
5
However, the effect of a restrictive approach on functional recovery or risk of myocardial infarction in patients . . .
Publisher
Massachusetts Medical Society
Subject
