Randomized controlled trials are needed to determine appropriate blood transfusion strategies in patients with acute coronary syndromes 英文参考文献.docVIP

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Randomized controlled trials are needed to determine appropriate blood transfusion strategies in patients with acute coronary syndromes 英文参考文献.doc

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Randomized controlled trials are needed to determine appropriate blood transfusion strategies in patients with acute coronary syndromes 英文参考文献

Available online at /content/9/3/E6 Evidence-Based Medicine Journal Club EBM Journal Club Section Editor: Eric B. Milbrandt, MD, MPH Journal club critique Randomized controlled trials are needed to determine appropriate blood transfusion strategies in patients with acute coronary syndromes Stephanie Freeman1 and Michael A. DeVita2 1 2 Clinical Fellow, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Associate Professor, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Published online: 18 March 2005 Critical Care 9: E6 (DOI 10.1186/cc) This article is online at /content/9/3/E6 ? 2005 BioMed Central Ltd Expanded Abstract Citation Outcomes: The primary outcome was 30-day all-cause mortality, with a secondary composite endpoint of 30-day mortality or myocardial infarction (MI). Rao SV, Jollis JG, Harrington RA, Granger CB, Newby LK, Armstrong PW, Moliterno DJ, Lindblad L, Pieper K, Topol EJ, Stamler JS, Califf RM: Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes. JAMA 2004, 292:1555-1562 [1]. Results Of the 24,112 patients, 2401 (10.0%) underwent at least one blood transfusion during their hospitalization. Those receiving blood were more likely to be older, female, black, have lower bodyweight, more comorbid illness, and ST segment depression on their initial EKG. Patients who underwent transfusion had a significantly higher unadjusted rate of 30-day death (8.00% vs. 3.08%; P.001), MI (25.16% vs. 8.16%; P.001), and death/MI (29.24% vs. 10.02%; P.001) as compared with patients who did not undergo transfusion. Background It is unclear if blood transfusion in anemic patients with acute coronary syndromes is associated with improved survival. Objective To determine the association between blood transfusion and mortality among patients with acute coronary syndromes who develop bleeding, anemia