OBJECTIVE: To examine the association between blood component transfusions and the incidence of major postoperative infections in patients undergoing esophageal resection surgery. DESIGN: Retrospective cohort study. SETTING: Single academic tertiary referral center. PARTICIPANTS: All patients who underwent esophagectomy from 2005 through 2009. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the incidence of major postoperative infection, defined as pneumonia, bloodstream infection, and/or a surgical site infection occurring within 30 days postoperatively. In total, 465 patients were evaluated. One hundred thirty-eight patients (29.7%) received a blood transfusion before the onset of a major postoperative infection or during a similar exposure interval in those with no such complications. Univariate analysis showed a significant association between any blood component transfusion and postoperative infection (transfused v nontransfused 31.9% v 13.2%; odds ratio = 3.1, 95% confidence interval = 1.9-5.0; p < 0.01). This association was lost on multivariate analysis. Subgroup analysis with multivariate adjustment identified a significant association between high plasma volume blood component transfusions and postoperative infection (odds ratio = 4.2, 95% confidence interval = 1.2-15.8; p = 0.03). With multivariate adjustment, red blood cell administration was no longer associated with major postoperative infectious complications. CONCLUSIONS: High plasma volume blood component transfusions were associated with the development of major postoperative infectious complications in patients undergoing esophageal resection surgery. In contrast, red blood cell transfusion was not associated with infectious complications.
OBJECTIVE: To examine the association between blood component transfusions and the incidence of major postoperative infections in patients undergoing esophageal resection surgery. DESIGN: Retrospective cohort study. SETTING: Single academic tertiary referral center. PARTICIPANTS: All patients who underwent esophagectomy from 2005 through 2009. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the incidence of major postoperative infection, defined as pneumonia, bloodstream infection, and/or a surgical site infection occurring within 30 days postoperatively. In total, 465 patients were evaluated. One hundred thirty-eight patients (29.7%) received a blood transfusion before the onset of a major postoperative infection or during a similar exposure interval in those with no such complications. Univariate analysis showed a significant association between any blood component transfusion and postoperative infection (transfused v nontransfused 31.9% v 13.2%; odds ratio = 3.1, 95% confidence interval = 1.9-5.0; p < 0.01). This association was lost on multivariate analysis. Subgroup analysis with multivariate adjustment identified a significant association between high plasma volume blood component transfusions and postoperative infection (odds ratio = 4.2, 95% confidence interval = 1.2-15.8; p = 0.03). With multivariate adjustment, red blood cell administration was no longer associated with major postoperative infectious complications. CONCLUSIONS: High plasma volume blood component transfusions were associated with the development of major postoperative infectious complications in patients undergoing esophageal resection surgery. In contrast, red blood cell transfusion was not associated with infectious complications.
Authors: Kai B Kaufmann; Wolfgang Baar; Torben Glatz; Jens Hoeppner; Hartmut Buerkle; Ulrich Goebel; Sebastian Heinrich Journal: BMC Anesthesiol Date: 2019-08-22 Impact factor: 2.217
Authors: Maximilian Dietrich; Tobias Hölle; Lazar Detelinov Lalev; Martin Loos; Felix Carl Fabian Schmitt; Mascha Onida Fiedler; Thilo Hackert; Daniel Christoph Richter; Markus Alexander Weigand; Dania Fischer Journal: J Clin Med Date: 2022-07-27 Impact factor: 4.964