1. In African children with uncomplicated severe anemia, immediate blood transfusion did not notably alter patient mortality at 1- or 6-months post treatment compared to patients treated under current practice.
2. Rates of hospital readmission, serious adverse events, and hemoglobin recovery were similar between the two groups.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Severe anemia, with hemoglobin <6 g/dl, is a leading cause of hospitalization in African children. Patients admitted for severe anemia have notable mortality rates. Due to resource limitations, transfusion for uncomplicated severe anemia is not advised if hemoglobin is between 4 and 6 g/dl. This randomized controlled trial evaluated patients who received immediate transfusion and those who did not, with no mortality difference observed between the two groups at 1 month or 6 months post randomization. Additionally, secondary outcomes of readmission, serious adverse events, and hemoglobin recovery at 6 months did not differ between the groups.
This study clinically evaluates patient outcomes observed for patients treated with notably different treatment thresholds, and secondarily evaluates resource utilization for context. Of note, hospital stay was longer for the control group and cost implications of monitoring are a consideration despite there being no observed mortality benefit to immediate transfusion.
Click to read the study in NEJM
Image: PD
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