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JAMA Clinical Evidence Synopsis
Clinician's Corner
January 2, 2013

Outcomes Using Lower vs Higher Hemoglobin Thresholds for Red Blood Cell Transfusion

Author Affiliations

JAMA Clinical Evidence Synopsis Section Editor: Mary McGrae McDermott, MD, Contributing Editor. We encourage authors to submit papers for consideration as a JAMA Clinical Evidence Synopsis. Please contact Dr McDermott at

Author Affiliations: Division of General Internal Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey (Dr Carson); Discipline of Clinical Pharmacology, Faculty of Health, University of Newcastle, Newcastle, Australia (Mr Carless); and Department of Medicine, Ottawa Hospital Research Institute, Ottawa, Canada (Dr Hébert).

JAMA. 2013;309(1):83-84. doi:10.1001/jama.2012.50429

Clinical Question: Is a lower vs higher hemoglobin threshold best for minimizing both red blood cell use and adverse clinical outcomes when used to trigger red blood cell transfusions in anemic patients in critical care and acute care settings?

Bottom Line: Compared with higher hemoglobin thresholds, a hemoglobin threshold of 7 or 8 g/dL is associated with fewer red blood cell units transfused without adverse associations with mortality, cardiac morbidity, functional recovery, or length of hospital stay.