Plasma transfusion is associated with postoperative infectious complications following esophageal resection surgery

A retrospective cohort study

Arun Subramanian, Elie F. Berbari, Michael J. Brown, Mark S. Allen, Anas Alsara, Daryl J Kor

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)569-574
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume26
Issue number4
DOIs
StatePublished - Aug 2012

Fingerprint

Blood Component Transfusion
Cohort Studies
Retrospective Studies
Infection
Plasma Volume
Multivariate Analysis
Odds Ratio
Confidence Intervals
Surgical Wound Infection
Erythrocyte Transfusion
Esophagectomy
Incidence
Tertiary Care Centers
Blood Transfusion
Pneumonia
Erythrocytes

Keywords

  • blood component transfusion
  • bloodstream infection
  • esophagectomy
  • postoperative pneumonia
  • postoperative wound infection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

Plasma transfusion is associated with postoperative infectious complications following esophageal resection surgery : A retrospective cohort study. / Subramanian, Arun; Berbari, Elie F.; Brown, Michael J.; Allen, Mark S.; Alsara, Anas; Kor, Daryl J.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 26, No. 4, 08.2012, p. 569-574.

Research output: Contribution to journalArticle

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abstract = "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.",
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