Transfusion Strategy for Hospitalized Patients with Anemia

A restrictive transfusion strategy (hemoglobin [Hb] cutoff, <7 g/dL) is accepted widely as the standard of care for most hospitalized patients with anemia, but controversy remains for some subgroups (NEJM JW Gen Med May 1 2021 and JAMA 2021; 325:552). In October 2023, the Association for the Advancement of Blood and Biotherapies conducted a systematic review to update their 2016 guideline (JAMA 2016; 316:2025) on red blood cell (RBC) transfusions. The updated guideline recommends the restrictive 7-g/dL cutoff for most hemodynamically stable patients, although clinicians “may choose” slightly higher thresholds for patients with preexisting cardiovascular disease and for patients undergoing orthopedic or cardiovascular surgery. However, for p…