Association between transfusion of stored blood and infective bacterial complications after resection for colorectal cancer.
OBJECTIVE
To examine the association between blood transfusion and bacterial infective complications after resection for colorectal adenocarcinoma.


METHODS
Retrospective cohort study.


METHODS
District hospital; Norway.


METHODS
446 consecutive patients having resection of colorectal adenocarcinoma.


METHODS
Postoperative bacterial infective morbidity in hospital.


RESULTS
112 patients (25%) developed postoperative infections in hospital. Univariate analysis showed that the development of infection was significantly associated with increasing age (p=0.02), rectal compared with colonic cancer (p=0.002), preoperative radiotherapy (p=0.005), blood loss during operation (p=0.001), the extent of the primary tumour (T stage): T4 compared with T1-T3 (p=0.004), the presence of regional lymph node metastasis (N stage): N1-N3 compared with N0 (p=0.01), operating surgeon 1 (p=0.009), operating surgeon 2 (p=0.03), and blood transfusion (p < 0.001). Multivariate logistic regression analysis showed that the following variables were independent predictors of infection: age, rectal compared with colonic cancer, T stage, N stage, and blood transfusion. The corrected odds ratios for infection were 1.5 (95% CI 0.8 to 2.8) when 1-3 units of blood were given and 3.1 (95% CI 1.6 to 6.0) when more than three units were given. Storage time did not affect the rate of postoperative infections in patients given transfusions.


CONCLUSIONS
Transfusion of non-filtered stored allogeneic blood suspended in saline-adenine-glucose-mannitol is an independent risk factor for the development of postoperative infections in hospital in patients having a resection of colorectal cancer.
Department of Surgery, Innherred Hospital, Levanger, Norway.
T H
TH
Edna
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Bjerkeset
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000209:etiology*; D001793:Blood Preservation; D003110:Colonic Neoplasms / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction