Perioperative red blood cell transfusion and outcome in stable patients after elective major vascular surgery.

Bursi F, Barbieri A, Politi L, et al.
Eur J Vasc Endovasc Surg 2009;37(3):311-318.
NATA Rating :
Review by : J. L. Carson
NATA Review

The literature is full of observational studies that show that blood is harmful. A recent systematic review by Malik and Corwin (Crit Care Med 2008;36:2667-74) found that in 42 of 45 observational studies he risk of transfusion outweighed the benefit. Unfortunately, it is not possible to fully control for confounding because blood transfusion is a marker for severity of disease. Only a randomized clinical trial can evaluate the risk vs. benefit of transfusion in an unbiased manner.

– Jeffrey L. Carson

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