Meta analysis on effect of liberal blood transfusion versus restrictive blood transfusion strategy on mortality of perioperative period and critically ill patients / 重庆医学

ABSTRACT

Objective To evaluate the effect of liberal transfusion versus restrictive transfusion strategies on the mortality rate of operative period and critically ill patients.Methods The domestic and abroad databases of WanFang Data,VIP,CBM,CNKI,Cochrane Library,PubMed,EMBASE,OVID and Web of Science were retrieved by computer.The randomized controlled trials(RCTs) on the effects of liberal blood transfusion versus restrictive blood transfusion strategies on the mortality were collected.The ¨Jadad scale¨ assessment tool provided by the Cochrane Collaboration was used to evaluate the quality of collected articles.Then the meta analysis was performed by using Review Manager(RevMan) version 5.3 software.Results Twenty-sevenRCTs involving 10 890 patients were included.The study indicated that there was no statistically significant difference between liberal transfusion group and restrictive transfusion group in the patients ' mortality[RR =0.97,95 ％ CI(0.83,1.13),P =0.69];the sub-group analysis showed that compared with the restrictive blood transfusion group,the liberal blood transfusion group could not effectively reduce the mortality of perioperative patients[RR=0.80,95 ％CI(0.62,1.03),P=0.08],and could not effectively reduce the mortality of critically ill patients[RR=1.09,95 ％CI(0.90,1.33),P =0.37].Conclusion The liberal blood transfusion can not significantly increase the survival rate of perioperative and critically ill patients compared with restrictive blood transfusion.