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Allogeneic Red Blood Cell Transfusion Is an Independent Risk Factor for the Development of Postoperative Bacterial Infection
Author(s) -
Chang Hong,
Hall Gregory A.,
Geerts William H.,
Greenwood Celia,
McLeod Robin S.,
Sher Graham D.
Publication year - 2000
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1046/j.1423-0410.2000.7810013.x
Subject(s) - medicine , perioperative , sepsis , risk factor , blood transfusion , confounding , surgery , red blood cell , abdominal surgery
Background and Objectives:Allogeneic red blood cell transfusions may exert immunomodulatory effects in recipients including an increased rate of postoperative bacterial infection. It is controversial whether allogeneic transfusion is an independent predictor for the development of postoperative bacterial infection. Methods: We analysed a prospectively collected database of 1,349 patients undergoing colorectal surgery in 11 centres across Canada. The primary outcome was the development of either a postoperative wound infection or intraabdominal sepsis in transfused and nontransfused patients. The effect of allogeneic transfusion on postoperative infection was evaluated with adjustment for all the confounding factors in a multiple regression analysis. Results: The 282 patients who received a total of 832 allogeneic units had a significantly higher frequency of wound infections and intra‐abdominal sepsis than the patients who were not transfused (25.9 vs. 14.2%, p = 0.001). A significant dose‐response relationship between transfusion and infectior, rate was demonstrated. Multiple regression analysis identified allogeneic transfusion as a statistically significant independent predictor for postoperative bacterial infection (OR 1.18, 95% CI 1.05–1.33, p = 0.007). Other independent predictors were anastomotic leak, repeat operation, patient age and preoperative haemoglobin level. The mortality rate was also significantly higher in the transfused group. Conclusion: These data support the hypothesis that allogeneic red cell transfusion is an independent risk factor for the development of postoperative bacterial infection in patients undergoing colorectal surgery. This association provides further reason to minimise exposure to allogeneic transfusions in the perioperative setting.