TY - JOUR
T1 - Plasma transfusion is associated with postoperative infectious complications following esophageal resection surgery
T2 - A retrospective cohort study
AU - Subramanian, Arun
AU - Berbari, Elie F.
AU - Brown, Michael J.
AU - Allen, Mark S.
AU - Alsara, Anas
AU - Kor, Daryl J.
PY - 2012/8
Y1 - 2012/8
N2 - 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.
AB - 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.
KW - blood component transfusion
KW - bloodstream infection
KW - esophagectomy
KW - postoperative pneumonia
KW - postoperative wound infection
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U2 - 10.1053/j.jvca.2011.12.015
DO - 10.1053/j.jvca.2011.12.015
M3 - Article
C2 - 22336690
AN - SCOPUS:84863433434
SN - 1053-0770
VL - 26
SP - 569
EP - 574
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 4
ER -