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Table 2 Summary of findings

From: Liberal versus restrictive red blood cell transfusion strategy in sepsis or septic shock: a systematic review and meta-analysis of randomized trials

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect: OR (95% CI)

No. of participants (no. of studies)

Certainty of evidence (GRADE)

Risk with restrictive RBC transfusion

Risk with liberal RBC transfusion

28- or 30-day mortality

362 per 1000

360 per 1000 (276–454)

0.99 (0.67–1.46)

1516 (3 RCTs)

Lowa,b

60-day mortality

452 per 1000

429 per 1000 (312–554)

0.91 (0.55–1.51)

1298 (2 RCTs)

Lowb,c

90-day mortality

493 per 1000

453 per 1000 (323–588)

0.85 (0.49–1.47)

1298 (2 RCTs)

Lowb,d

No. of patients transfused with RBC in the ICU

585 per 1000

933 per 1000 (355–997)

9.94 (0.39–250.88)

1277 (2 RCTs)

Lowb,e

Ventilation use at 28 days

146 per 1000

147 per 1000 (81–250)

1.01 (0.52–1.96)

1277 (2 RCTs)

Lowb,f

Vasopressor use at 28 days

66 per 1000

69 per 1000 (28–161)

1.06 (0.41–2.72)

1277 (2 RCTs)

Lowb,g

RRT at 28 days

66 per 1000

64 per 1000 (41–99)

0.97 (0.60–1.57)

1277 (2 RCTs)

Moderateb

No. of patients transfused with FFP in the ICU

186 per 1000

205 per 1000 (163–257)

1.13 (0.85–1.51)

1277 (2 RCTs)

Moderateb

No. of patients transfused with platelet in the ICU

146 per 1000

165 per 1000 (120–221)

1.16 (0.80–1.67)

1277 (2 RCTs)

Moderateb

  1. Grades of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group
  2. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
  3. Moderate certainty: We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  4. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
  5. Very low certainty: We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of the effect
  6. *The risk in the intervention group (and its 95% confidence interval [CI]) was based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  7. aHeterogeneity was observed among the studies (I2 = 61.0%, χ2 = 5.13, p = 0.08). Downgraded by 1
  8. bIndirectness such as different populations of patients was observed in the studies. Downgraded by 1
  9. cHeterogeneity was observed among the studies (I2 = 72.0%, χ2 = 3.63, p = 0.06). Downgraded by 1
  10. dHeterogeneity was observed among the studies (I2 = 77.0%, χ2 = 4.27, p = 0.04.) Downgraded by 1
  11. eHeterogeneity was observed among the studies (I2 = 98.0%, χ2 = 46.53, p < 0.01). Downgraded by 1
  12. fHeterogeneity was observed among the studies (I2 = 75.0%, χ2 = 4.04, p = 0.04). Downgraded by 1
  13. gHeterogeneity was observed among the studies (I2 = 71.0%, χ2 = 3.49, p = 0.06). Downgraded by 1
  14. RBC red blood cell, OR odds ratio, RCT randomized controlled trial, ICU intensive care unit, RRT renal replacement therapy, FFP fresh frozen plasma
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Critical Care

ISSN: 1364-8535