White‐blood‐cell‐containing allogeneic blood transfusion and postoperative infection or mortality: an updated meta‐analysis
Bibliographic record
Abstract
BACKGROUND: Additional randomized controlled trials (RCTs) comparing recipients of non-white-blood-cell-(WBC)-reduced and WBC-reduced allogeneic red blood cells (RBCs) have been reported since the undertaking of previous meta-analyses of the association of allogeneic blood transfusion (ABT) with postoperative infection and/or mortality. Because no further RCTs are underway, a final meta-analysis of all available RCTs was conducted. METHODS: RCTs reporting on the association of ABT with postoperative infection and/or short-term (up to 3-month post-transfusion), all-cause mortality were retrieved. Twelve RCTs reporting on infection and 11 RCTs reporting on mortality were eligible for meta-analysis. Summary odds ratios (ORs) of infection or mortality in recipients of WBC-containing ABT vs. WBC-reduced ABT were calculated across the studies. RESULTS: An association of ABT with postoperative infection was demonstrated across RCTs transfusing RBCs WBC-reduced after storage [summary OR = 2.25; 95% confidence interval (CI), 1.12-4.25] but not before storage (summary OR = 1.06; 95% CI, 0.91-1.24). An association of ABT with mortality was demonstrated across RCTs conducted in cardiac surgery (summary OR = 1.72, 95% CI, 1.05-2.81) and across RCTs transfusing buffy-coat-reduced RBCs vs. RBCs WBC-reduced before storage (summary OR = 1.60; 95% CI, 1.14-2.24), but not across RCTs transfusing non-buffy-coat-reduced RBCs vs. RBCs WBC-reduced before storage (summary OR = 1.01; 95% CI, 0.73-1.40). CONCLUSIONS: An association between ABT and postoperative infection or short-term mortality is not detected across all clinical settings and transfused RBC products. An association between ABT and mortality is detected in cardiac surgery, but the other associations found in subgroup analyses contradict current theories about mechanism(s) of the ABT effect.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.043 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.058 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".