Age of red cells for transfusion and outcomes in critically ill adults

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults. METHODS: In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. RESULTS: From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P = 0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P = 0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome. CONCLUSIONS: The age of transfused red cells did not affect 90-day mortality among critically ill adults.

Original languageEnglish
Pages (from-to)1858-1867
Number of pages10
JournalNew England Journal of Medicine
Volume377
Issue number19
DOIs
Publication statusPublished - 9 Nov 2017

Keywords

  • blood, transfusion, red blood cells, fresh. red-cell storage, clinical trial

Cite this

@article{35d1ced380e6447286eedcf517a16f82,
title = "Age of red cells for transfusion and outcomes in critically ill adults",
abstract = "BACKGROUND: It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults. METHODS: In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. RESULTS: From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5{\%}) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8{\%}) in the short-term storage group and 594 (24.1{\%}) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95{\%} confidence interval [CI], -1.7 to 3.1; P = 0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95{\%} CI, -2.1 to 3.0; P = 0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome. CONCLUSIONS: The age of transfused red cells did not affect 90-day mortality among critically ill adults.",
keywords = "blood, transfusion, red blood cells, fresh. red-cell storage, clinical trial",
author = "Cooper, {D. James} and McQuilten, {Zoe K.} and Alistair Nichol and Bridget Ady and Cecile Aubron and Michael Bailey and Rinaldo Bellomo and Dashiell Gantner and Irving, {David O.} and Kirsi-Maija Kaukonen and Colin McArthur and Lynne Murray and Ville Pettila and Craig French",
year = "2017",
month = "11",
day = "9",
doi = "10.1056/NEJMoa1707572",
language = "English",
volume = "377",
pages = "1858--1867",
journal = "New England Journal of Medicine",
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Age of red cells for transfusion and outcomes in critically ill adults. / Cooper, D. James; McQuilten, Zoe K.; Nichol, Alistair; Ady, Bridget; Aubron, Cecile; Bailey, Michael; Bellomo, Rinaldo; Gantner, Dashiell; Irving, David O.; Kaukonen, Kirsi-Maija; McArthur, Colin; Murray, Lynne; Pettila, Ville; French, Craig.

In: New England Journal of Medicine, Vol. 377, No. 19, 09.11.2017, p. 1858-1867.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Age of red cells for transfusion and outcomes in critically ill adults

AU - Cooper, D. James

AU - McQuilten, Zoe K.

AU - Nichol, Alistair

AU - Ady, Bridget

AU - Aubron, Cecile

AU - Bailey, Michael

AU - Bellomo, Rinaldo

AU - Gantner, Dashiell

AU - Irving, David O.

AU - Kaukonen, Kirsi-Maija

AU - McArthur, Colin

AU - Murray, Lynne

AU - Pettila, Ville

AU - French, Craig

PY - 2017/11/9

Y1 - 2017/11/9

N2 - BACKGROUND: It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults. METHODS: In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. RESULTS: From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P = 0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P = 0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome. CONCLUSIONS: The age of transfused red cells did not affect 90-day mortality among critically ill adults.

AB - BACKGROUND: It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults. METHODS: In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. RESULTS: From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P = 0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P = 0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome. CONCLUSIONS: The age of transfused red cells did not affect 90-day mortality among critically ill adults.

KW - blood, transfusion, red blood cells, fresh. red-cell storage, clinical trial

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U2 - 10.1056/NEJMoa1707572

DO - 10.1056/NEJMoa1707572

M3 - Article

VL - 377

SP - 1858

EP - 1867

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

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