Findings from two recently completed studies could shed some new light on the most effective clinical practices for transfusion. Both of the investigations discussed at the AABB Annual Meeting session “Hot Topics: Randomized Clinical Trials in Transfusion Medicine” attempted to answer questions that have perplexed clinicians for years: Under what circumstances should there be a transfusion, and what is the optimal dose to help improve patient safety?
In the FOCUS trial, researchers looked at patients with heart disease or serious risk factors for heart disease undergoing surgery for hip fracture. The overall goal of the trial, which enrolled 2,016 patients at 47 centers in the U.S. and Canada, was to determine whether a more aggressive transfusion strategy was warranted for these patients and whether it would contribute to improved functional recovery and decreased risk of adverse post-operative outcomes. The investigators analyzed whether there were any differences in clinical outcomes between two approaches: transfusion when a patient’s hemoglobin concentration fell below 10 grams per deciliter within three days of surgery and transfusion based on symptoms or hemoglobin concentration less than 8 grams per deciliter.