We are already moving to decreasing transfusions in general for most of our hospital patients
But now there is evidence that more transfusions can lead to an increase in nosocomial infections
JAMA Meta-Analysis
18 randomized trials with 7,593 patients
All tested higher vs lower transfusion thresholds in a variety of inpatient settings
Hospital-acquired infections were the outcome
What they found
Absolute risk for nosocomial infection was 17% among patients with a higher hemoglobin target compared to 12% with a lower target
NNT to avoid an infection was 38 using a restrictive transfusion strategy
Bottom Line
Potential cost savings to the healthcare industry with less transfusions
For most patients, a hemoglobin > 7 g/dL is just fine
References
Rohde J, et al. Health Care Associated Infection after Red Blood Cell Transfusion. A systematic Review adn Meta-Analysis. JAMA 2014; 311(13): 1317-1326.
