title: Plasma transfusion is associated with postoperative infectious complications following esophageal resection surgery: a retrospective cohort study.
abstract: OBJECTIVE
  To examine the association between blood component transfusions and the incidence of major postoperative infections in patients undergoing esophageal resection surgery.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Single academic tertiary referral center.
  
  
  METHODS
  All patients who underwent esophagectomy from 2005 through 2009.
  
  
  RESULTS
  The primary outcome was the incidence of major postoperative infection, defined as pneumonia, bloodstream infection, and/or a surgical site infection occurring within 30 days postoperatively. In total, 465 patients were evaluated. One hundred thirty-eight patients (29.7%) received a blood transfusion before the onset of a major postoperative infection or during a similar exposure interval in those with no such complications. Univariate analysis showed a significant association between any blood component transfusion and postoperative infection (transfused v nontransfused 31.9% v 13.2%; odds ratio = 3.1, 95% confidence interval = 1.9-5.0; p < 0.01). This association was lost on multivariate analysis. Subgroup analysis with multivariate adjustment identified a significant association between high plasma volume blood component transfusions and postoperative infection (odds ratio = 4.2, 95% confidence interval = 1.2-15.8; p = 0.03). With multivariate adjustment, red blood cell administration was no longer associated with major postoperative infectious complications.
  
  
  CONCLUSIONS
  High plasma volume blood component transfusions were associated with the development of major postoperative infectious complications in patients undergoing esophageal resection surgery. In contrast, red blood cell transfusion was not associated with infectious complications.
authors.affiliation: Department of Anesthesiology, Division of Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. subramanian.arun@mayo.edu
authors.forename: Arun
authors.initials: A
authors.lastname: Subramanian
authors.forename: Elie F
authors.initials: EF
authors.lastname: Berbari
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Brown
authors.forename: Mark S
authors.initials: MS
authors.lastname: Allen
authors.forename: Anas
authors.initials: A
authors.lastname: Alsara
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Kor
mesh_terms: D000368:Aged; D016913:Blood Component Transfusion / Q000009:adverse effects*; D015331:Cohort Studies; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology*