Association of bacterial infection and red blood cell transfusion after coronary artery bypass surgery.
BACKGROUND
Previous studies have shown an association between red blood cell transfusions (RBC) and bacterial infections following coronary artery bypass graft (CABG) surgery. We sought to assess whether there is an independent effect of RBC on the incidence of bacterial infections.


METHODS
This was a prospective cohort study of 533 CABG patients over a 7-month period. Subjects were followed from time of CABG until 30 days postoperatively. Data were collected on patient and treatment characteristics, surgical management, and transfusion incidence.


RESULTS
Seventy-five (14.1%) of 533 patients developed a bacterial infection. After controlling for patient and disease characteristics, invasive treatments, surgical time, and the transfusion of other substances, the adjusted rates of bacterial infection were 4.8% for no RBC transfusion, 15.2% with one to two units, 22.1% with three to five units, and 29.0% with greater than or equal to six units, (p(trend) < 0.001). Diabetes was the only patient or disease factor significantly associated with bacterial infection (p < 0.001).


CONCLUSIONS
RBC transfusions were independently associated with a higher incidence of post-CABG bacterial infections. The risk of infection increased in proportion to the number of units of RBC transfused.
Chelemer
Scott B
SB
Department of Medicine, Maine Medical Center, Portland 04102, USA.
Prato
B Stephen
BS
Cox
Paul M
PM
O'Connor
Gerald T
GT
Morton
Jeremy R
JR
D000328:Adult; D001424:Bacterial Infections / Q000209:etiology*; D001026:Coronary Artery Bypass; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology*; D011184:Postoperative Period; D011446:Prospective Studies