The impact of a restrictive transfusion trigger on post-operative complication rate and well-being following elective orthopaedic surgery: a post-hoc analysis of a randomised study.

So-Osman et al. undertook a post-hoc analysis of their previous randomized trial on transfusion triggers. In their 2010 publication, the “restrictive” strategy implemented in one of the three hospitals involved in the trial was, in fact, more liberal than the local, existing transfusion policy. In their re-analysis of the data, patients who were assigned to the most restrictive transfusion strategy were compared to those assigned to the most liberal transfusion strategy.

The authors confirm that well-being (quality of life) was not associated with transfusion policy or with red blood cell transfusions. Further, they now present data showing that a restrictive transfusion protocol was not associated with worse outcome and resulted in a lower transfusion rate compared to the liberal policy.

– Jean-François Hardy