BACKGROUND: Many retrospective studies report increased postoperative infection after allogenic blood transfusion. To investigate this phenomenon, we prospectively studied 232 patients undergoing cardiac surgery. METHODS: Patients were screened daily for evidence of culture positive infections. Wounds were examined daily and defined on the ASEPSIS score. Chest radiographs and white cell counts and differentials were recorded on days 1, 2, and 4. The use of blood products was monitored blindly and independently. Patients were grouped according to transfusion status and compared using chi2 or Fisher's test. Logistic regression analyses were performed to identify predictors of transfusion and infection. RESULTS: Of 232 patients, 116 (50%) received blood product transfusion. Patients receiving blood had lower preoperative hemoglobin, were older, with a greater proportion of urgent/emergency or revision surgery, and were higher risk. Despite this, there were no differences in the frequency of chest infection (20% versus 15%, p = 0.38), urinary infection (3.5% versus 5.3%, p = 0 0.75), wound infection (3.5% versus 8.0%, p = 0.16), or overall infection (28% versus 30%, p = 0.89) comparing the transfused versus untransfused groups. There was no evidence to suggest that administration of blood products was associated with infection (odds ratio 0.92, p = 0.77). CONCLUSIONS: The administration of blood per se did not lead to increased postoperative infection. Clinicians should reconsider withholding blood transfusion in patients solely owing to concerns of predisposition to infection.
BACKGROUND: Many retrospective studies report increased postoperative infection after allogenic blood transfusion. To investigate this phenomenon, we prospectively studied 232 patients undergoing cardiac surgery. METHODS:Patients were screened daily for evidence of culture positive infections. Wounds were examined daily and defined on the ASEPSIS score. Chest radiographs and white cell counts and differentials were recorded on days 1, 2, and 4. The use of blood products was monitored blindly and independently. Patients were grouped according to transfusion status and compared using chi2 or Fisher's test. Logistic regression analyses were performed to identify predictors of transfusion and infection. RESULTS: Of 232 patients, 116 (50%) received blood product transfusion. Patients receiving blood had lower preoperative hemoglobin, were older, with a greater proportion of urgent/emergency or revision surgery, and were higher risk. Despite this, there were no differences in the frequency of chest infection (20% versus 15%, p = 0.38), urinary infection (3.5% versus 5.3%, p = 0 0.75), wound infection (3.5% versus 8.0%, p = 0.16), or overall infection (28% versus 30%, p = 0.89) comparing the transfused versus untransfused groups. There was no evidence to suggest that administration of blood products was associated with infection (odds ratio 0.92, p = 0.77). CONCLUSIONS: The administration of blood per se did not lead to increased postoperative infection. Clinicians should reconsider withholding blood transfusion in patients solely owing to concerns of predisposition to infection.
Authors: Jacob R Gillen; James M Isbell; Alex D Michaels; Christine L Lau; Robert G Sawyer Journal: Surg Infect (Larchmt) Date: 2015-06-26 Impact factor: 2.150
Authors: Keith A Horvath; Michael A Acker; Helena Chang; Emilia Bagiella; Peter K Smith; Alexander Iribarne; Irving L Kron; Pamela Lackner; Michael Argenziano; Deborah D Ascheim; Annetine C Gelijns; Robert E Michler; Danielle Van Patten; John D Puskas; Karen O'Sullivan; Dorothy Kliniewski; Neal O Jeffries; Patrick T O'Gara; Alan J Moskowitz; Eugene H Blackstone Journal: Ann Thorac Surg Date: 2013-05-03 Impact factor: 4.330
Authors: Shaikhah Awadh Al-Harbi; Noura Alkhayal; Afrah Alsehali; Shatha Alshaya; Wesam Bin Obaid; Alaa Althubaiti; R E van Onselen; Mohmed Al Annany; Ahmed A Arifi Journal: J Saudi Heart Assoc Date: 2019-07-02