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Red Blood Cell Transfusion in Patients With Traumatic Brain Injury: A Systematic Review and Meta-Analysis.
Amélie Boutin1, Michaël Chassé2, Michèle Shemilt3
1CHU de Québec-Université Laval Research Center (Hôpital de l'Enfant-Jésus), Population Health and Optimal Health Practices Research Unit, Université Laval, Quebec City, QC, Canada; Department of Social and Preventive Medicine, Université Laval, Quebec City, QC, Canada.
Red blood cell (RBC) transfusions are common in patients with traumatic brain injury (TBI), affecting 36% of individuals. Transfusion practices vary widely, with no clear evidence guiding strategies for TBI patients.
Area of Science:
- Neuroscience
- Hematology
- Critical Care Medicine
Background:
- Traumatic brain injury (TBI) is a significant cause of mortality and morbidity.
- Red blood cell (RBC) transfusion is a common intervention in critically ill patients, but its role in TBI management is not well-defined.
Purpose of the Study:
- To determine the frequency of RBC transfusions in TBI patients.
- To identify factors associated with RBC transfusion in TBI.
- To evaluate the outcomes of RBC transfusion in TBI patients.
Main Methods:
- Systematic review and meta-analysis of cohort studies and randomized trials.
- Searched major databases (Medline, Embase, Cochrane, BIOSIS) up to April 2015.
- Pooled data on transfusion incidence, determinants, and outcomes using random-effect models.
Main Results:
- Approximately 36% of TBI patients received RBC transfusions.
- Transfused patients had lower Glasgow Coma Scale scores on admission.
- No significant difference in mortality was observed between transfused and non-transfused patients.
- Hospital length of stay was longer for transfused patients.
Conclusions:
- RBC transfusion is frequent in TBI patients, with wide variations in transfusion thresholds.
- Current evidence does not support specific transfusion strategies for TBI.
- Further research is needed to guide RBC transfusion practices in TBI.
