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Transfusion policy for postoperative patients can be either liberal (maintaining the hemoglobin at a level of ≥10 g/dL) or restrictive (giving blood only when the hemoglobin is <8 g/dL or for symptoms of anemia). Although the liberal use of transfusions might improve myocardial oxygenation, blood has effects on the immune system that might increase future risk for infections and cancer.
To compare long-term outcomes associated with both transfusion strategies, investigators randomized 2016 patients undergoing surgery for hip fracture to liberal or restrictive use of blood transfusion. All patients had risk factors for cardiovascular disease and a hemoglobin <10 g/dL during the first 3 postoperative days.
During a median follow-up of 3.1 years…