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  • Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality - A pooled patient data analysis of 16 observational trials

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    Author(s)
    Ng, MSY
    David, M
    Middelburg, RA
    Ng, ASY
    Suen, JY
    Tung, JP
    Fraser, JF
    Griffith University Author(s)
    Fraser, John F.
    David, Michael
    Year published
    2018
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    Abstract
    Observational studies address packed red blood cell effects at the end of shelf life and have larger sample sizes compared to randomized control trials. Meta-analyses combining data from observational studies have been complicated by differences in aggregate transfused packed red blood cell age and outcome reporting. This study abrogated these issues by taking a pooled patient data approach. Observational studies reporting packed red blood cell age and clinical outcomes were identified and patient-level data sets were sought from investigators. Odds ratios and 95% confidence intervals for binary outcomes were calculated for ...
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    Observational studies address packed red blood cell effects at the end of shelf life and have larger sample sizes compared to randomized control trials. Meta-analyses combining data from observational studies have been complicated by differences in aggregate transfused packed red blood cell age and outcome reporting. This study abrogated these issues by taking a pooled patient data approach. Observational studies reporting packed red blood cell age and clinical outcomes were identified and patient-level data sets were sought from investigators. Odds ratios and 95% confidence intervals for binary outcomes were calculated for each study, with mean packed red blood cell age or maximum packed red blood cell age acting as independent variables. The relationship between mean packed red blood cell age and hospital length of stay for each paper was analyzed using zero-inflated Poisson regression. Random effects models combined paper-level effect estimates. Extremes analyses were completed by comparing patients transfused with mean packed red blood cell aged less than ten days to those transfused with mean packed red blood cell aged at least 30 days. sixteen datasets were available for pooled patient data analysis. Mean packed red blood cell age of at least 30 days was associated with an increased risk of in-hospital mortality compared to mean packed red blood cell of less than ten days (odds ratio: 3.25, 95% confidence interval: 1.27–8.29). Packed red blood cell age was not correlated to increased risks of nosocomial infection or prolonged length of hospital stay.
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    Journal Title
    Haematologica
    Volume
    103
    Issue
    9
    DOI
    https://doi.org/10.3324/haematol.2018.191932
    Copyright Statement
    © Ferrata Storti Foundation 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License, which permits unrestricted distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Cardiovascular medicine and haematology
    Publication URI
    http://hdl.handle.net/10072/385274
    Collection
    • Journal articles

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