A restrictive blood transfusion strategy (HGB <7.5 g/dL) was equivalent to a liberal strategy (HGB <9.5 g/dL in the OR or ICU and HGB<8.5 g/dL in the non-ICU ward) with regard to mortality and major disability in cardiac surgery patients who had a moderate-to-high risk of death, this study finds.
The primary composite outcome−death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis by discharge or postoperative day 28−occurred in 11.4% of patients in the restrictive group and 12.5% in the liberal group.
Mortality was 3.0% and 3.6% in the restrictive group and liberal group, respectively.
These outcomes were achieved with fewer units of blood being transfused−red-cell transfusion occurred in 52.3% of patients in the restrictive group and 72.6% in the liberal group.
The study involved 4,860 patients (2,430 in each group) at 73 sites in 19 countries.
The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear.