Evidence map›Paper›PMID 40659365›Full record

ArticleJournal of hospital medicine2026

Variation in effectiveness of blood transfusion by hospital day: A multicenter retrospective study.

Nicholas A Bosch, Anica C Law, Nareg H Roubinian, S Reza Jafarzadeh, Allan J Walkey

Abstract readMulticenter Study
In one paragraph

Article in Journal of hospital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nicholas A BoschThe Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-7161-5254
Anica C LawThe Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
Nareg H RoubinianThe Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA.
S Reza JafarzadehSection of Rheumatology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-1099-9175
Allan J WalkeyDepartment of Medicine, Division of Health Systems Science, UMass Chan Medical School, Worcester, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4685-6894

Funding

A Learning Health System Approach to Improve the Effectiveness of Blood Transfusions during Septic ShockK23HL173709 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Nicholas A Bosch · 2024 to 2026
$514k
NHLBI NIH HHS K23 HL173709NHLBI NIH HHS K23HL173709-01NIH HHS
6 · The paper itself

Abstract

backgroundTransfusion of packed red blood cells (pRBCs) below a hemoglobin concentration of 7.0 g/dL is common, but it is unclear if the timing of transfusion during hospitalization modifies transfusion effectiveness. We sought to determine if effects of pRBC transfusion are heterogenous based on time from hospital admission.

methodsMulticenter retrospective cohort study including hospitals in the Premier Inc. AI Healthcare Database between 2016 and 2022. Hospital encounters for adults with at least one hemoglobin concentration measured between hospital Days 1-7 were included. For each day, the lowest hemoglobin concentration was identified; patient-days were then separated into seven analytic cohorts based on the day in which a hemoglobin concentration was recorded (index day). We used regression discontinuity to quantify the effect of index day pRBC transfusion versus no transfusion on an outcome of hospital mortality or discharge to hospice (risk difference [RD]) at a hemoglobin concentration threshold of 7.0 g/dL in each cohort.

resultsA total of 2,293,021 index days across 997,277 inpatient encounters were included. The association between pRBC transfusion and hospital mortality or discharge to hospice differed based on days from admission, shifting from benefit on Day 1 (RD: -2.9 [95% CI: -5.9, -0.04] %) to harm on index Days 6 and 7 (Day 6, RD: 3.3 [95% CI: 0.4, 6.1] %; Day 7, RD: 4.1 [95% CI: 0.8, 7.3] %, p-interaction < .0001).

conclusionsTransfusion during hospitalization was associated with benefit early in hospitalization and harm at later time points.

Indexed as

Blood TransfusionErythrocyte TransfusionHospitalizationAgedFemaleHemoglobinsHospital MortalityHumansMaleMiddle AgedRetrospective StudiesTime FactorsHemoglobins

Identifiers

PMID40659365
PMCPMC12635911

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.