Patient blood management interventions do not lead to important clinical benefits or cost-effectiveness for major surgery: a network meta-analysis
Marius Roman, Riccardo Abbasciano, Suraj Pathak, Shwe Oo, Syabira Yusoff, Marcin Woźniak, Saqib Qureshi, Florence Lai, Tracy Kumar, Toby Richards, Guiqing Yao, Lise J Estcourt, Gavin J. Murphy
Abstract
BACKGROUND: Patient blood management (PBM) interventions aim to improve clinical outcomes by reducing bleeding and transfusion. We assessed whether existing evidence supports the routine use of combinations of these interventions during and after major surgery. METHODS: . Network meta-analyses used a frequentist approach. The protocol was registered prospectively (PROSPERO CRD42018085730). RESULTS: =0%). Treatment effects were consistent across multiple secondary outcomes, sub-groups and sensitivity analyses that considered clinical setting, type of intervention, and trial quality. Network meta-analysis did not demonstrate additive benefits from the use of multiple interventions. No trial demonstrated that PBM was cost-effective. CONCLUSIONS: In randomised trials, PBM interventions do not have important clinical benefits beyond reducing bleeding and transfusion in people undergoing major surgery.