title: Restrictive blood transfusion strategies and associated infection in orthopedic patients: a meta-analysis of 8 randomized controlled trials.
abstract: This study sought to evaluate whether restrictive blood transfusion strategies are associated with a risk of infection in orthopedic patients by conducting a meta-analysis of randomized controlled trials (RCTs). RCTs with restrictive versus liberal red blood cell (RBC) transfusion strategies were identified by searching Medline, Embase, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews from their inception to December 2014. Eight RCTs with infections as outcomes were included in the final analysis. According to the Jadad scale, all studies were considered to be of high quality. The pooled risk ratio [RR] for the association between transfusion strategy and infection was 0.65 (95% CI, 0.47-0.91; p = 0.012), and the number of patients needed to treat to avoid an infection using a restrictive transfusion strategy was 62. No heterogeneity was observed. The sensitivity analysis indicated unstable results, and no significant publication bias was observed. This meta-analysis of RCTs demonstrates that restrictive transfusion strategies in orthopedic patients result in a significant reduction in infections compared with more liberal strategies.
authors: Department of Orthopedic Surgery, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi 653100, Yunan, China.
authors: Zhaowei
authors: Z
authors: Teng
authors: Department of Nephrology, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi 653100, Yunan, China.
authors: Yun
authors: Y
authors: Zhu
authors: Department of Orthopedics of the Affiliated Hospital of Hebei University of Engineering, China.
authors: Yugang
authors: Y
authors: Liu
authors: Department of Orthopedics of the Second Affiliated Hospital of Harbin Medical University, China.
authors: Guojun
authors: G
authors: Wei
authors: Department of Orthopedic Surgery, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi 653100, Yunan, China.
authors: Shuangneng
authors: S
authors: Wang
authors: Department of Orthopedic Surgery, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi 653100, Yunan, China.
authors: Shaoliang
authors: S
authors: Du
authors: Department of Orthopedic Surgery, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, 21 Nieer Road, Yuxi 653100, Yunan, China.
authors: Xiguang
authors: X
authors: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology*; D001803:Blood Transfusion / Q000379:methods* / Q000706:statistics & numerical data*; D015897:Comorbidity; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D015994:Incidence; D038622:Internationality; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*