Restrictive Blood Transfusion Practice in a Medical Intensive Care Unit: A Real Life Data from the Northern Turkey

Anemia is a common problem encountered by patients hospitalized in the intensive care unit (ICU). However, the relationship between transfusion and mortality has not been clearly determined. We aimed to investigate the effects of a restrictive transfusion practice on patient outcomes in the ICU. We enrolled 143 patients who were hospitalized in the ICU between August 2018 and August 2019. Patients were categorized by whether they had received transfusion during their stay. Transfusions were performed according to a restrictive transfusion policy with a hemoglobin (Hb) threshold of < 7 g/dL. Transfusion was required for 43% of the patients with a median of 3 units used. Transfused patients were older (79.3 vs. 74.6 years; p = 0.034), had greater length of stay (LOS) in the ICU (LOS-ICU: 51 vs. 9.5 days; p = < 0.001), were under invasive mechanic ventilation (LOS-IMV: 20 vs. 7.5 days; p = 0.026), and higher mortality rates (68.9% vs. 37.8%; p = < 0.001) than those who did not. Age (odds ratio [OR]: 1.03), sepsis or septic shock (OR: 2.74), placement of central venous catheter (OR: 6.36), and LOS-ICU (OR: 1.01) were defined as predictors of transfusion. However, after hierarchical logistic regression analyses, mortality rates were not associated with transfusion. The need for vasopressor use (OR: 17.3) and IMV (OR: 38.3) were predictors of mortality. Although transfused patients were more severely ill, whether they underwent transfusion or not did not correlate with increased mortality rates. Selecting a restrictive transfusion policy and shortening LOS-ICU might provide better patient outcomes. While this study supports restrictive transfusion policies, it primarily contributes region-specific data rather than novel or generalizable findings.