title: Allogenic blood transfusion does not predispose to infection after cardiac surgery.
abstract: BACKGROUND
  Many retrospective studies report increased postoperative infection after allogenic blood transfusion. To investigate this phenomenon, we prospectively studied 232 patients undergoing cardiac surgery.
  
  
  METHODS
  Patients were screened daily for evidence of culture positive infections. Wounds were examined daily and defined on the ASEPSIS score. Chest radiographs and white cell counts and differentials were recorded on days 1, 2, and 4. The use of blood products was monitored blindly and independently. Patients were grouped according to transfusion status and compared using chi2 or Fisher's test. Logistic regression analyses were performed to identify predictors of transfusion and infection.
  
  
  RESULTS
  Of 232 patients, 116 (50%) received blood product transfusion. Patients receiving blood had lower preoperative hemoglobin, were older, with a greater proportion of urgent/emergency or revision surgery, and were higher risk. Despite this, there were no differences in the frequency of chest infection (20% versus 15%, p = 0.38), urinary infection (3.5% versus 5.3%, p = 0 0.75), wound infection (3.5% versus 8.0%, p = 0.16), or overall infection (28% versus 30%, p = 0.89) comparing the transfused versus untransfused groups. There was no evidence to suggest that administration of blood products was associated with infection (odds ratio 0.92, p = 0.77).
  
  
  CONCLUSIONS
  The administration of blood per se did not lead to increased postoperative infection. Clinicians should reconsider withholding blood transfusion in patients solely owing to concerns of predisposition to infection.
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital, Papworth Everard, Cambridge, United Kingdom.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Ali
authors.forename: Eric
authors.initials: E
authors.lastname: Lim
authors.forename: Reza
authors.initials: R
authors.lastname: Motalleb-Zadeh
authors.forename: Ayyaz A
authors.initials: AA
authors.lastname: Ali
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Callaghan
authors.forename: Caroline
authors.initials: C
authors.lastname: Gerrard
authors.forename: Alain
authors.initials: A
authors.lastname: Vuylsteke
authors.forename: Juliet
authors.initials: J
authors.lastname: Foweraker
authors.forename: Steven
authors.initials: S
authors.lastname: Tsui
mesh_terms: D000368:Aged; D000740:Anemia / Q000628:therapy; D019072:Antibiotic Prophylaxis; D016913:Blood Component Transfusion / Q000009:adverse effects / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures; D015897:Comorbidity; D004198:Disease Susceptibility; D004630:Emergencies; D004739:England / Q000453:epidemiology; D005260:Female; D005436:Floxacillin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D016037:Single-Blind Method; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D065227:Transfusion Reaction; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology
chemical_list: D005436:Floxacillin