| Title: |
Restrictive Versus A Liberal Transfusion Strategy in Patients With Spontaneous Intracerebral Hemorrhage: A Secondary Analysis of TRAIN Randomized Clinical Trial |
| Authors: |
Faso, Chiara; Gouvea Bogossian, Elisa; Bittencourt Rynkowski, Carla; Moller, Kirsten; Lormans, Piet; Quintana Diaz, Manuel; Caricato, Anselmo; Dabrowski, Wojciech; Gonzalez Perez, Isabel; Steblaj, Simona; Quintard, Herve; Justo, Pilar; Righy, Cassia; Roman Pognuz, Erik; Huet, Olivier; Mahmoodpoor, Ata; Blandino-Ortiz, Aaron; Junttila, Eija; Funes, Nidya; Izzo, Gabriella; Zattera, Luigi; Giacomucci, Angelo; Dibu, Jamil; Rodrigues, Aurore; Bouzat, Pierre; Vincent, Jean-Louis; Taccone, Fabio Silvio; TRAIN Study Trial Group; Díaz, Claudia; Saravia, Andrés; Bayrlee, Ahmad; Nedolast, Laura; Elkambergy, Hussam; Siddique, Haamid; Mallat, Jihad; AlJaberi, Nahla; Shoshan, Samer; Mandi, Ayo; De Oliveira, Bruno; Prasanna, Malligere; Haque, Rehan; Munde, Dnyaneshwar; Chaffee, Sara; Alawadhi, Fatma; Luoto, Teemu; Šteblaj, Simona; Creteur, Jacques; Durand, Dominique; Abbenhuijs, Caroline; Itesa Matumikina, Nancy; Annoni, Filippo; Nobile, Leda; Ulloa Bersatti, Miguel; Yovenko, Igor; Tsarev, Alexander; Dubois, Jasperina; Voets, Evy; Janssen, Luc; Pedrosa, Leire; Badenes, Rafael; Monleon Lopez, Berta; Serrano, Ainhoa; Wittebole, Xavier; Silva, Serena; Dell'Anna, Antonio Maria; Gelormini, Camilla; Stival, Eleonora; Marcos Neira, Pilar; Roig Pineda, Regina; Bielsa Berrocal, Lara; Misis del Campo, Maite; Bendel, Stepani; Mejía-Mantilla, Jorge H; Marulanda, Ángela; Damgaard Nielsen, Rune; Harboe Olsen, Markus; Ravnholt Jensen, Helene; Møller Larsen, Ida; Kurtz, Pedro; Tallarico, Roberta; Lucangelo, Umberto; Ichai, Carole; Cinotti, Raphael; Asenhoune, Karim; Lakhal, Karim; Chabanne, Russell; Fernandez-Canal, Charlotte; Gay, Samuel; Lebouc, Marie; Bougon, David; Escudier, Etienne; Sirodot, Michel; Levrat, Albrice; Courouau, Alix; Duranteau, Jacques; Makouche, Naima; Videtta, Walter; Francony, Gilles; Vincent, Olivier; Boucheix, Perrine; Schilte, Clotilde; Cecile Fevre, Marie; Mistral, Thomas; Richard, Marion; Salah, Samia; Banco, Pierluigi; Pollet, Angelina; Adolle, Anais; Gargadennec, Thomas; Dias, Patricia; Desanglois, Gwenaelle; Meheut, Alexia; Cam, Pauline; Meyfroidt, Geert; Mebis, Liese; Hendrickx, Alexandra; Wouters, Pieter; Van Hulle, Sylvia; D'Hondt, Alain; Beumier, Marjorie; Burgeois, Marc; Simonet, Olivier; Vallot, Frederic; Centeno, Pablo; Anchorena, Matias; Benavente, Ximena; D'Onofrio, Maximilian; Barra de Oca, Antonio; Castelain, Charlotte; Soetens, Filip; Colpaert, Kirsten; Arias, Mario; Morocho, Diego; Jabaja, Manuel; Tutillo, Diego; Popugaev, Stan; Dias, Celeste; Perez Solada, Elena; Lopez Gomez, Amparo; Alcantara, Sara; Chico, Francisco; Fernanda Garcia, Maria; Picoita, Fabricio; Antonio, Marco; Ferreira, Cardoso; Petterson, Leticia; Lemke, Daniel; Baastrup Søndergaard, Christian; Velasco Eichler, Stela; Bianchi, Gabriela Nonticuri; Pedro Britz, João; Almeida Pimentel, Jaqueline; Sérgio Fernandes, Mário; Gharsallah, Hedi; Hajjej, Zied; Samoud, Walid; Grebenchikov, Oleg; Likhvantsev, Valery; Stroiteleva, Elena; Markou, Nikolaos; Bakali, Dimitra; Koutrafouri, Dionysia; Subhy Alsheikhly, Ahmed; Maccherani, Sara; Horn, Janneke; Elbahnasawy, Mohamed; Ahmadi, Arezoo; Vandewaeter, Catherine; Decaesteker, Lien; Decruyenaere, Daphne; Demeersseman, Ruth; Devriendt, Yves; Embo, Karen; van der Jagt, Mathieu; van Duijn, Ditty; Ormskerk, Patricia; Glasbergen-van Beijeren, Melanie |
| Contributors: |
Faso, Chiara; Gouvea Bogossian, Elisa; Bittencourt Rynkowski, Carla; Moller, Kirsten; Lormans, Piet; Quintana Diaz, Manuel; Caricato, Anselmo; Dabrowski, Wojciech; Gonzalez Perez, Isabel; Steblaj, Simona; Quintard, Herve; Justo, Pilar; Righy, Cassia; Roman Pognuz, Erik; Huet, Olivier; Mahmoodpoor, Ata; Blandino-Ortiz, Aaron; Junttila, Eija; Funes, Nidya; Izzo, Gabriella; Zattera, Luigi; Giacomucci, Angelo; Dibu, Jamil; Rodrigues, Aurore; Bouzat, Pierre; Vincent, Jean-Loui; Taccone, Fabio Silvio; Train Study Trial, Group; Díaz, Claudia; Saravia, André; Bayrlee, Ahmad; Nedolast, Laura; Elkambergy, Hussam; Siddique, Haamid; Mallat, Jihad; Aljaberi, Nahla; Shoshan, Samer; Mandi, Ayo; De Oliveira, Bruno; Prasanna, Malligere; Haque, Rehan; Munde, Dnyaneshwar; Chaffee, Sara; Alawadhi, Fatma; Luoto, Teemu; Šteblaj, Simona; Creteur, Jacque; Durand, Dominique; Abbenhuijs, Caroline; Itesa Matumikina, Nancy; Annoni, Filippo; Nobile, Leda; Ulloa Bersatti, Miguel; Yovenko, Igor; Tsarev, Alexander; Dubois, Jasperina; Voets, Evy; Janssen, Luc; Pedrosa, Leire; Badenes, Rafael; Monleon Lopez, Berta; Serrano, Ainhoa; Wittebole, Xavier; Silva, Serena; Dell'Anna, Antonio Maria; Gelormini, Camilla; Stival, Eleonora; Marcos Neira, Pilar; Roig Pineda, Regina; Bielsa Berrocal, Lara; Misis Del Campo, Maite; Bendel, Stepani; Mejía-Mantilla, Jorge H; Marulanda, Ángela; Damgaard Nielsen, Rune; Harboe Olsen, Marku; Ravnholt Jensen, Helene; Møller Larsen, Ida; Kurtz, Pedro; Tallarico, Roberta; Lucangelo, Umberto; Ichai, Carole; Cinotti, Raphael; Asenhoune, Karim; Lakhal, Karim; Chabanne, Russell; Fernandez-Canal, Charlotte; Gay, Samuel; Lebouc, Marie; Bougon, David; Escudier, Etienne; Sirodot, Michel; Levrat, Albrice; Courouau, Alix; Duranteau, Jacque; Makouche, Naima; Videtta, Walter; Francony, Gille; Vincent, Olivier; Boucheix, Perrine |
| Publication Year: |
2025 |
| Collection: |
Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste) |
| Subject Terms: |
critical illne; hemoglobin; human; odds ratio; random allocation |
| Description: |
BACKGROUND: Red blood cell transfusions are commonly administered to anemic patients with spontaneous intracerebral hemorrhage (ICH); however, the optimal hemoglobin threshold to initiate transfusion is uncertain in this population. Therefore, we aimed to assess the impact of 2 different hemoglobin thresholds to guide transfusion on the neurological outcome of anemic critically ill patients with ICH. METHODS: This is a secondary analysis of a prospective, multicenter, phase 3 randomized study conducted in 72 intensive care units across 22 countries from 2017 to 2022. Eligible patients for the original trial had an acute brain injury, hemoglobin values ≤9 g/dL within the first 10 days after admission, and an expected intensive care unit stay of at least 72 hours; in this study, only patients with spontaneous ICH were assessed. Patients were randomly assigned to undergo a restrictive (transfusion triggered by hemoglobin ≤7 g/dL) or a liberal (transfusion triggered by hemoglobin ≤9 g/dL) strategy over a 28-day period. The primary outcome was the occurrence of an unfavorable neurological outcome, defined as a Glasgow Outcome Scale Extended score of 1 to 5, at 180 days following randomization. RESULTS: A total of 144 patients with spontaneous ICH were analyzed: 45.8% of them were male, with a mean age of 58.4 (SD, 13.4). Mean Glasgow Coma Scale on admission was 7.3 (SD, 3.3), and 75.7% of patients had a volume of hematoma >30 mL. Among all patients, 73 were randomized to the restrictive transfusion strategy, while 71 to the liberal one. Baseline characteristics were comparable between the 2 groups. At 180 days after randomization, patients assigned to the liberal transfusion strategy had a nonsignificant decrease in the probability of unfavorable neurological outcome (71.8 versus 84.7%; risk ratio, 0.85 [95% CI, 0.71-1.01]; P=0.06). Also, the occurrence of the composite outcome (mortality and organ failure at day 28) was significantly lower in the liberal group (71.8% versus 87.7%, risk ratio, 0.82 [95% CI, ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40525290; info:eu-repo/semantics/altIdentifier/wos/WOS:001555389800037; volume:56; issue:9; firstpage:2617; lastpage:2626; numberofpages:10; journal:STROKE; https://hdl.handle.net/11368/3113659 |
| DOI: |
10.1161/strokeaha.125.050729 |
| DOI: |
10.1161/STROKEAHA.125.050729 |
| Availability: |
https://hdl.handle.net/11368/3113659; https://doi.org/10.1161/strokeaha.125.050729; https://www.ahajournals.org/doi/10.1161/STROKEAHA.125.050729 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license:Digital Rights Management non definito ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/ ; license uri:iris.PRI00 |
| Accession Number: |
edsbas.9BF73522 |
| Database: |
BASE |