Bleeding, Transfusion, and Mortality on Extracorporeal Life Support: ECLS Working Group on Thrombosis and Hemostasis (Mazzeffi M, Greenwood J, Tanaka K, Menaker J, Rector R, Herr D, Kon Z, Lee J, Griffith B, Rajagopal K, Pham S)

36, 46

Track red cell units transfused as a quantitative marker; the adjusted association with mortality attached to transfusion volume rather than to bleeding per se in this cohort.

No bleeding; per-unit transfusion

DOI 10.1016/j.athoracsur.2015.07.046; PMID 26443879

Exposure: serious bleeding events and red cell transfusion

Single centre, small, retrospective; wide confidence intervals; abstract only read; transfusion lies on the causal path of bleeding.

Serious bleeding 56.1% (74/132), 10 events per 100 days. Crude OR death with bleeding 2.22 (1.00-4.94); adjusted 0.90 (0.37-2.19). Per RBC unit crude 1.03 (1.01-1.04), adjusted 1.03 (1.00-1.06, p=0.04). 90-day survival trend lower with bleeding (46.7% vs 64.9%, p=0.08).

132 adult ECLS patients, single centre (University of Maryland), about 3 years. Ann Thorac Surg 2016;101(2):682-689.