Bruun-Rasmussen P, et al. Intervening on the storage time of RBC units and its effects on adverse recipient outcomes using real-world data. Blood. 2022; doi: 10.1182/blood.2022015892.
A study at the University of Copenhagen investigated the adverse effects of the storage of red blood cell (RBC) units. This study was conducted using real-world data from a Danish blood transfusion database from 2008-2018, marginal structural models (MSM) to estimate the potential causal effect of transfusing RBC units with different storage durations, and a unique directed acyclic graph (DAG) of study assumptions used to suggest and adjust covariates for subsequent statistical modeling adjustment.
- Enrollment: 89,799 patients receiving more than 340,000 RBC transfusions met the eligibility criteria (massive transfusion patients were excluded).
- Endpoints: An individual receiving >1-week old blood has a 2.44% higher chance of dying during a 28-day follow-up period than someone receiving ≤ 1-week old blood and a 2.29% higher chance of dying or having a thromboembolic event during a 28-day follow-up period than someone receiving ≤ 1-week old blood
This study suggests that transfusing exclusively older RBC units stored for >1 or 2 weeks increases the 28-day recipient mortality and risk of thromboembolism or death compared with transfusing fresher RBC units.