Landmark Series
Methodology Score: 3.5/5 Usefulness Score: 4/5
Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C. N Engl J Med.2013 Jan 3;368(1):11-21
Article Link
This RCT comparing a restrictive versus liberal transfusion strategy (N=921) in acute upper GI bleeding showed that for patients who have rapid access to endoscopy (within 6 hours), a restrictive strategy (transfuse hgb < 7 g/dL) was associated with a higher probability of survival at 6 weeks (HR 0.55; 95% CI 0.33-0.92) and less adverse events (HR 0.73; 0.56-0.95) compared to a liberal strategy (transfuse hgb < 9 g/dL). This was the first large prospective RCT to address this issue and the group agreed that this was practice changing; however, it is difficult to apply the results of this study to those who have endoscopy after 6 hours. By: Dr. Anita Lai (Presented June 2013)
Methodology Score: 3.5/5 Usefulness Score: 4/5
Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C. N Engl J Med.2013 Jan 3;368(1):11-21
Article Link
This RCT comparing a restrictive versus liberal transfusion strategy (N=921) in acute upper GI bleeding showed that for patients who have rapid access to endoscopy (within 6 hours), a restrictive strategy (transfuse hgb < 7 g/dL) was associated with a higher probability of survival at 6 weeks (HR 0.55; 95% CI 0.33-0.92) and less adverse events (HR 0.73; 0.56-0.95) compared to a liberal strategy (transfuse hgb < 9 g/dL). This was the first large prospective RCT to address this issue and the group agreed that this was practice changing; however, it is difficult to apply the results of this study to those who have endoscopy after 6 hours. By: Dr. Anita Lai (Presented June 2013)