This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Cardiovascular System, Other  • Evidence-Based Medicine  • Vascular Surgery  • Blood/ Coagulation  • Randomized Controlled Trial  • Alert me on articles by topic  Social Bookmarking   What's this?

Meta-analysis of Randomized Controlled Trials

Hisato Takagi, MD, PhD; Seishiro Sekino, MD; Takayoshi Kato, MD; Yukihiro Matsuno, MD, PhD; Takuya Umemoto, MD, PhD

Arch Surg. 2007;142(11):1098-1101.

Objective  To determine whether intraoperative autotransfusion reduces the percentage of patients undergoing allogeneic blood transfusion.

Data Sources and Study Selection  Using a public domain database (MEDLINE) and a Web-based search engine (PubMed), all intraoperative autotransfusion vs control prospective randomized controlled trials that enrolled patients undergoing elective infrarenal abdominal aortic aneurysm surgery, published between January 1, 1966, and November 30, 2005, were searched. Relevant studies were identified through a manual search of secondary sources including references of initially identified articles.

Data Extraction  Data on detailed inclusion criteria, autotransfusion system type, and incidence of allogeneic blood transfusion were abstracted from each study. Sensitivity analyses were performed by excluding individual trials one at a time and recalculating the pooled risk ratio estimates for the remaining studies.

Data Synthesis  Our search identified 4 randomized controlled trials including data for 292 patients. Pooled analysis demonstrated a statistically significant 37% reduction in risk of allogeneic blood transfusion with intraoperative autotransfusion compared with control (risk ratio, 0.63; 95% confidence interval, 0.41-0.95; P = .03) in a random-effects model. There was statistically significant trial heterogeneity of results (P = .02) but no evidence of statistically significant publication bias (P = .497). Two of 4 sensitivity analyses demonstrated statistically nonsignificant results favoring intraoperative autotransfusion.

Conclusion  Based on a meta-analysis of available randomized controlled trials, intraoperative autotransfusion reduces risk of allogeneic blood transfusion in elective infrarenal abdominal aortic aneurysm surgery.

Author Affiliations: Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Intraoperative Autotransfusion in Abdominal Aortic Aneurysm Surgery: Meta-analysis of Randomized Controlled Trials—Invited Critique
Paul N. Suding and Samuel Eric Wilson
Arch Surg. 2007;142(11):1102.
EXTRACT | FULL TEXT