Clinical Outcomes of Blood Transfusion

In examining transfusion decisions, we examined the role of severity of illness and patient comorbidities in relation to hemoglobin levels in hospitalized patients. The finding that decisions were based on hemoglobin levels likely stemmed from broad acceptance of transfusion guidelines of restrictive red blood cell (RBC) transfusion practice and played a role in the 25% decline in RBC utilization over five years. We characterized this reduction in RBC utilization in hospitalized medical and surgical patients from 21 hospitals and found that unadjusted and adjusted mortality rates were unchanged, controlling for patient factors and hemoglobin levels. Current investigations include examining the effects of patient blood management and blood donor characteristics, such as age and gender, on transfused patient outcomes.

Selected Publications:

Roubinian N, Murphy EL, Swain BE, Gardner MN, Liu V, Escobar GJ. Predicting Red Blood Cell Transfusion in Hospitalized Patients: Role of Hemoglobin Level, Comorbidities, and Illness Severity. BMC Health Serv Res. 2014 May 10;14:213.

Roubinian NH, Escobar GJ, Liu V, Gardner MN, Carson JL, Kleinman SH et al for the NHLBI Recipient Epidemiology and Donor Evaluation Study (REDS-III). Decreased red blood cell use and mortality in hospitalized patients. JAMA Intern Med. 2014 Aug;174(8):1405-7.

Roubinian NH, Escobar GJ, Liu V, Swain BE, Gardner MN, Kipnis P et al for the NHLBI Recipient Epidemiology and Donor Evaluation Study (REDS-III). Trends in red blood cell transfusion and 30-day mortality among hospitalized patients. Transfusion. 2014 Oct;54(10 Pt 2):2678-86.

Roubinian N, Carson JL. Red blood cell transfusion strategies in adult and pediatric patients with malignancy. Hematol Oncol Clin North Am. 2016 Jun;30(3):529-40.

Carson JL, Stanworth SJ, Roubinian N, Fergusson DA, Triulzi D, Doree C et al. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev. 2016 Oct 12