Does blood transfusion increase the risk of infection after hip fracture?
OBJECTIVE
To determine whether allogeneic red blood cell transfusion is a predictor for developing an in-hospital postoperative urinary tract, respiratory, or wound infection.


METHODS
Prospective, consecutive.


METHODS
Six hundred eighty-seven community-dwelling, ambulatory, geriatric hip fracture patients were prospectively followed; all patients had operative fracture treatment and received perioperative antibiotics.


RESULTS
Sixty-eight patients had a culture-positive infection before operative treatment. One hundred thirty-four of the remaining 619 patients (21.6%) developed a postoperative infection, primarily a urinary tract infection. The infection rate was 26.8% in transfused patients compared with 14.9% in nontransfused patients (p = 0.001). When stratifying by the type of infection, only the risk of urinary tract infection was statistically significant (p = 0.001). After controlling for the effect of patient age, sex, number of preinjury medical comorbidities, American Society of Anesthesiologists (ASA) rating of operative risk, fracture type, surgical delay, type of surgery, type of anesthesia, operative time, and blood loss, the relationship between allogeneic red blood cell transfusion and postoperative urinal tract infection remained statistically significant.


CONCLUSIONS
Geriatric hip fracture patients who receive allogeneic red blood cell transfusions are at higher risk for developing a postoperative urinary tract infection than are those patients who are not transfused.
Koval
K J
KJ
Department of Orthopaedics, Hospital for Joint Diseases, New York, New York 10003, USA.
Rosenberg
A D
AD
Zuckerman
J D
JD
Aharonoff
G B
GB
Skovron
M L
ML
Bernstein
R L
RL
Su
E
E
Chakka
M
M
D000368:Aged; D000369:Aged, 80 and over; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000209:etiology; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology*