title: Timing and incidence of postoperative infections associated with blood transfusion: analysis of 1,489 orthopedic and cardiac surgery patients.
abstract: BACKGROUND
  Transfusion rates remain high in cardiac and orthopedic surgery and differ widely across physician practices in spite of growing knowledge that allogeneic blood transfusion (ABT) is associated with a risk of postoperative infection.
  
  
  METHODS
  This prospective observational study compared the timing and incidence of ABT-associated postoperative infections (PIs) in 1,489 orthopedic or cardiac surgery patients at nine hospitals.
  
  
  RESULTS
  Of 455 cardiovascular and 1,034 orthopedic surgery patients, 415 (55.6% of the cardiovascular patients and 15.7% of the orthopedic patients) were given ABT. The overall rate of PI during hospitalization was 5.8%. The relative risk of PI was 3.6-fold greater after ABT (50 patients; 12.1%) than in patients not having ABT (36 patients; 3.4%; 95% confidence interval 2.4, 5.4; p = 0.001). Postoperative infections appeared both during hospitalization (n = 86) and within four weeks after discharge (n = 81).
  
  
  CONCLUSIONS
  Patients should be followed for as long as four weeks after discharge to determine the true incidence and risk of ABT-associated PI.
authors: Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey 07631, USA. aryeh.shander@ehmc.com
authors: Aryeh
authors: A
authors: Shander
authors: Richard K
authors: RK
authors: Spence
authors: David
authors: D
authors: Adams
authors: Linda
authors: L
authors: Shore-Lesserson
authors: Cynthia A
authors: CA
authors: Walawander
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology*; D013903:Thoracic Surgery; D013997:Time Factors; D065227:Transfusion Reaction; D055815:Young Adult