Work

Perioperative Transfusion Trigger Score Versus Restrictive Transfusion in Older Non‐Cardiac Surgery Patients: A Multicenter Randomized Controlled Trial

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: BACKGROUND: , temperature, and angina history, may standardize decisions and safely reduce transfusions in older non-cardiac surgery patients. METHODS: ≥ 95%), core temperature, and angina; transfusion when Hb < POTTS. Control followed 2012 AABB guideline (Hb < 7 always transfuse; > 10 not; 7-10 physician discretion). PRIMARY OUTCOME: proportion receiving allogeneic RBC transfusion during perioperative period (ITT population). RESULTS: 253 patients (mean age 72.3 years; 67.6% women) were randomized (May 2023-Sept 2025). Baseline Hb similar (median 9.60 vs. 9.50 g/dL). In ITT, transfusion required in 24.00% (30/125) of POTTS vs. 35.94% (46/128) of control (p = 0.038). Transfusion volume did not differ significantly (median 2.50 vs. 3.00 units, p = 0.520). Overall complication rates: 12.80% vs. 8.59% (p = 0.279); one death in control group (0.85%). No significant differences in specific complications. CONCLUSION: In patients ≥ 60 years undergoing non-cardiac surgery, POTTS-guided transfusion significantly reduced the proportion of patients transfused without increasing complications. TRIAL REGISTRATION: This study was registered at http://www.chictr.org.cn (#ChiCTR2300071739).

Source: Journal of the American Geriatrics Society

DOI: 10.1111/jgs.70575