Red blood cell transfusion in patients with traumatic brain injury: a systematic review
We identified 21 eligible studies (16,951 patients). After pooling data from the 20
included cohort studies (16,884 patients), at least around 33% (95% CI: 27 to 39;
I2: 97.8%) of patients with TBI in published reports received transfusions at some point
during their hospital stay. In a post hoc analysis of one RCT comparing transfusion strategies, 82% of patients were transfused
RBCs. Thresholds for transfusion were rarely available and varied from 6 to 10 g/dl.
From raw data, Glasgow Coma Scale scores were lower in patients who were transfused
than those who were not (three cohort studies; n = 1,371; mean difference of 1.38
points (95% CI: 0.86 to 1.89); I2 = 12%). Mortality was not significantly different among transfused and nontransfused
patients both in univariate and multivariate analyses. Hospital length of stay was
longer among patients who were transfused (three studies; n = 455; mean difference 9.58 days (95% CI: 3.94 to 15.22); I2 = 74%). Due to the observational nature of included studies, results should be considered
cautiously due to the high risk of confounding.