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Acute upper gastrointestinal bleeding (AUGIB) is a common indication for red blood cell transfusions (RBCT). In a recent study, a restrictive approach to RBCT was associated with a lower mortality in patients with AUGIB (NEJM JW Hosp Med Mar 2013 and N Engl J Med 2013; 368:11). Subsequent meta-analyses have cast doubt on this finding.
To compare clinical outcomes between restrictive (threshold hemoglobin <70 or 80 g/L) and liberal RBCT strategies in patients with AUGIB, investigators performed a literature search and a meta-analysis of data from five prospective randomized, controlled trials comprising 1965 patients.
Patients treated with a restrictive approach to RBCT had a lower mortality risk (pooled relative risk, 0.65); the number needed…