Transfusion Evidence Alert and Round-Up

On this page you can view articles from previous editions of the Transfusion Evidence Alert and Round-Up. You can also use the button on the left to sign up to receive future editions direct to your inbox.

The Transfusion Evidence Alert is a monthly overview of the top ten evidence-based publications in the field of transfusion medicine. The articles are selected for quality and relevance by clinical experts, supported by members of the Systematic Review Initiative.

The Transfusion Evidence Round-Up is a quarterly overview of the top 10 high quality studies about an internationally relevant subject in the field of transfusion medicine. The articles are selected by members from the International Society of Blood Transfusion and drawn from the Transfusion Evidence Library and, where relevant, Stem Cell Evidence.

Register here to receive the free monthly Transfusion Evidence Alert and the quarterly Round-Up direct to your email account each month.
Editor's Choice

Risk factors for bleeding in people living with hemophilia A and B treated with regular prophylaxis: A systematic review of the literature

J Thromb Haemost. 2022 Jun;20(6):1364-1375 doi: 10.1111/jth.15723.
PICO Summary
POPULATION:

People living with haemophilia (PWH) A and B treated with regular prophylaxis (10 studies).

INTERVENTION:

Systematic review on risk assessment models and risk factors for bleeding.

COMPARISON:

OUTCOME:

No risk assessment model for the risk for bleeding was found. Most studies included only PWH A or both PWH A and B and were conducted in North America or Europe. Only one study had a low risk for bias in all the domains. Eight categories of risk factors were identified. The risk for bleeding was increased when factor levels were lower and in people with a significant history of bleeding or who engaged in physical activities involving contact.

Abstract
BACKGROUND:

Knowledge about the risk for bleeding in patients with hemophilia (PWH) would be relevant for patients, stakeholders, and policy makers.

OBJECTIVES:

To perform a systematic review of the literature on risk assessment models (RAMs) and risk factors for bleeding in PWH on regular prophylaxis.

METHODS:

We searched Medline, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from inception through August 2019. In duplicate, reviewers screened the articles for inclusion, extracted data, and assessed the risk for bias using the Quality in Prognostic Studies (QUIPS) tool. A qualitative synthesis of the results was not performed due to high heterogeneity in risk factors, outcomes definition and measurement, and statistical analysis of the results.

RESULTS:

From 1843 search results, 10 studies met the inclusion criteria. No RAM for the risk for bleeding in PWH was found. Most studies included only PWH A or both PWH A and B and were conducted in North America or Europe. Only one study had a low risk for bias in all the domains. Eight categories of risk factors were identified. The risk for bleeding was increased when factor levels were lower and in people with a significant history of bleeding or who engaged in physical activities involving contact.

CONCLUSIONS:

Our findings suggest that plasma factor levels, history of bleeds, and physical activity should be considered for the derivation analysis when building a RAM for bleeding in PWH, and the role of other risk factors, including antithrombotic treatment and obesity, should be explored.

Metadata
KEYWORDS: bleeding; hemophilia A; hemophilia B; hemorrhage; risk assessment; risk factors
MESH HEADINGS: Europe; Hemophilia A; Hemorrhage; Humans; Risk Factors
Study Details
Study Design: Systematic Review
Language: eng
Credits: Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine