Abstract
Red blood cell (RBC) transfusion is frequently administered to patients after cardiac arrest; however, its association with patient outcomes has not been well established. This study investigated the association between early RBC transfusion after the return of spontaneous circulation (ROSC) and patient outcomes in adults with cardiac arrest. We analyzed data from 586 adult patients who achieved ROSC at two university-affiliated hospitals in Korea between August 2014 and December 2023. Early transfusion was defined as RBC transfusion administered within 24 h after ROSC. Overlap propensity score weighting was used to adjust for confounding, and weighted analysis was performed to assess associations between early transfusion and patient outcomes. Within 24 h after ROSC, 79 patients (13.5%) received RBC transfusions. Early RBC transfusion was not significantly associated with 30-day mortality (adjusted hazard ratio [aHR] 0.97, 95% confidence interval [CI] 0.65–1.47), 90-day mortality (aHR 0.95, 95% CI 0.64–1.42), in-hospital mortality (adjusted odds ratio [aOR] 0.99, 95% CI 0.91–1.07), or neurologic outcome (aOR 0.97, 95% CI 0.92–1.03). Consistent findings were observed when early transfusion was defined as occurring within 48 or 72 h after ROSC. The number of RBC units transfused was also not associated with patient outcomes. Early RBC transfusion after ROSC was not associated with survival or neurologic outcomes in patients with cardiac arrest.
Data availability
The de-identified patient data is available from the corresponding authors, on reasonable request.
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Funding
This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2023-0111).
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CHL—Data curation, Investigation, Writing—original draft. JHC—Data curation, Writing—original draft. SSK—Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Visualization, Writing—original draft. JM—Conceptualization, Data curation, Methodology, Resources, Writing—review & editing. SK—Conceptualization, Supervision, Writing—review & editing. IP—Conceptualization, Supervision, Writing—review & editing. HSC—Conceptualization, Supervision, Writing—review & editing.
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This study was reviewed and approved by the Institutional Review Board of the Yonsei University Health System (4-2024-0333) and was conducted in accordance with the principles of the Declaration of Helsinki. The requirement for informed consent was waived owing to the retrospective nature of the study and the use of de-identified data.
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Lee, C.H., Choi, J.H., Kim, S. et al. Association between early red blood cell transfusion after return of spontaneous circulation and clinical outcomes in cardiac arrest patients. Sci Rep (2026). https://doi.org/10.1038/s41598-026-41690-1
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DOI: https://doi.org/10.1038/s41598-026-41690-1
