Neuroanaesthesia & neurocritical care
Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage
Primary resultResult — go to the resultRelative risk 0.88 95% CI 0.72–1.09Authors' conclusion
In patients with aneurysmal subarachnoid hemorrhage and anemia, a liberal transfusion strategy did not result in a lower risk of an unfavorable neurologic outcome at 12 months than a restrictive strategy.
Study context
- Population
- Critically ill adults with acute aneurysmal SAH and anemia725 analysed
- Participants
- 742 adults
- Comparison
- Liberal vs restrictive RBC transfusion strategy
- Liberal strategyn = 364
- Restrictive strategyn = 361reference
- Primary endpoint
- Unfavorable neurologic outcome (modified Rankin scale score ≥4; range 0–6, higher = greater disability)
- Follow-up
- 12 months
Methodological detailsmulticentre, 23 centres
- Multicentre
- 23 centres
Primary result
As reported in the abstract
Relative risk
0.88
95% CI 0.72–1.09
P = 0.22
Events by treatment group
Liberal strategy vs Restrictive strategy
RR 0.88 (95% CI 0.72–1.09); P = 0.22
Secondary outcomes
Mean
| Outcome | Liberal strategy | Restrictive strategy | Mean difference (95% CI) | |
|---|---|---|---|---|
| Functional independence (FIM, range 18–126) · 12 months | 82.8 (SD 54.6) | 79.8 (SD 54.5) | 3.01 (−5.49 to 11.51) | |
| Quality of life (EQ-5D-5L utility index, range −0.1 to 0.95) · 12 months | 0.5 (SD 0.4) | 0.5 (SD 0.4) | 0.02 (−0.04 to 0.09) | |
| Quality of life (VAS, range 0–100) · 12 months | 52.1 (SD 37.5) | 50 (SD 37.1) | 2.08 (−3.76 to 7.93) | |
| −10−5051015Difference (linear scale) |
Safety
Adverse events
- Incidence similar in the two groups
Original publication
Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage. N Engl J Med. Published 9 December 2024. doi:10.
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