The impact of storage time of transfused blood on postoperative infectious complications in rectal cancer surgery. Danish RANX05 Colorectal Cancer Study Group.
BACKGROUND
We have studied the impact of storage time of transfused allogeneic blood together with other known risk factors on postoperative infectious complications after operation for rectal cancer.


METHODS
Intra-abdominal abscess, anastomotic leakage, septicaemia, wound infection, and pneumonia were prospectively recorded in 303 patients undergoing elective resection for primary rectal cancer in 18 Danish hospitals. Patient risk variables and variables related to operation technique and transfusion were recorded prospectively, whereas amount given before infectious complication and storage time of saline-adenine-glucose-mannitol (SAGM) blood, administered to each patient, were recorded retrospectively.


RESULTS
The overall infection rate was 24% in 78 non-transfused and 40% in 225 transfused patients (P = 0.011). The proportion of SAGM blood stored for > or = 21 days administered to each transfused patient was a median of 60% in patients developing postoperative infections versus 25% (P = 0.037) in patients without infections. A multivariate analysis of significant risk variables showed weight > 75 kg (odds ratio, 2.0 versus < 65 kg) and transfusion of SAGM blood stored > or = 21 days (odds ratio, 2.5 versus no transfusion) to be independent variables predicting infectious complications.


CONCLUSIONS
Blood storage time may, along with other risk factors, play a significant role in blood transfusion-associated development of postoperative infectious complications.
Mynster
T
T
Dept. of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Nielsen
H J
HJ
D000368:Aged; D001793:Blood Preservation; D001803:Blood Transfusion; D013505:Digestive System Surgical Procedures; D004356:Drug Storage; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors