Pitfalls in the current published observational literature on the effects of red blood cell storage.

摘要

Possible adverse effects related to transfusing "old" red blood cells (RBCs) have been investigated extensively. As the ongoing randomized controlled trials (RCTs) on the effects of RBC storage may still take years to report their results, current RBC storage and transfusion policies will have to be based on the currently available, mostly observational, literature. These observational studies are valuable, as they may rationally direct the formulation of sound hypotheses. However, the results from these observational studies on storage time are conflicting, making it impossible to reach a consensus. This is not solely based on the limitations of the observational design of the studies. On close examination, a large number of the published observational studies have failed to evade pitfalls in performing RBC storage research. Here, several aspects of study design and analyses are discussed that illustrate pitfalls that may result in seriously biased comparisons and unsupported conclusions.