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Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults

Version 2 2024-06-03, 17:34
Version 1 2018-11-27, 10:14
journal contribution
posted on 2024-06-03, 17:34 authored by D James Cooper, Zoe K McQuilten, Alistair Nichol, Bridget Ady, Cecile Aubron, Michael Bailey, Rinaldo Bellomo, Dashiell Gantner, David O Irving, Kirsi-Maija Kaukonen, Colin McArthur, Lynne Murray, Ville Pettila, Craig French
BACKGROUND: It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults. METHODS: In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. RESULTS: From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P=0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P=0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome. CONCLUSIONS: The age of transfused red cells did not affect 90-day mortality among critically ill adults. (Funded by the Australian National Health and Medical Research Council and others; TRANSFUSE Australian and New Zealand Clinical Trials Registry number, ACTRN12612000453886 ; ClinicalTrials.gov number, NCT01638416 .).

History

Journal

NEW ENGLAND JOURNAL OF MEDICINE

Volume

377

Pagination

1858-1867

Location

United States

ISSN

0028-4793

eISSN

1533-4406

Language

English

Publication classification

C Journal article, C1.1 Refereed article in a scholarly journal

Copyright notice

2017, Massachusetts Medical Society.

Issue

19

Publisher

MASSACHUSETTS MEDICAL SOC