title: Transfusion of packed red blood cells stored >14 days was associated with a higher risk of infection after hip revision arthroplasty.
abstract: OBJECTIVE
  Transfusion of packed red blood cells (RBCs) stored for &gt;14 days has been associated with a higher risk of infection but there is no data about the impact in revision hip arthroplasty.
  
  
  METHODS
  We retrospectively reviewed 280 patients who underwent revision hip arthroplasty from January 2002 to May 2012. Relevant risk factors and prosthetic joint infection (PJI) rate after 100 days after surgery were collected.
  
  
  RESULTS
  10 patients out of 280 (3.6%) had a PJI within the first 100 days after revision surgery. The PJI rate in patients receiving an early transfusion (during surgery or within the first 12 hours) of packed RBCs with a length of storage &gt;14 days was higher (8.0%) than the rate in nontransfused patients (1.8%) or those receiving an early transfusion of packed RBCs with a length of storage ≤14 days (2.6%, p = 0.05). A Cox regression model identified transfusion of packed RBCs stored &gt;14 days as the only independent predictor of PJI (hazard ratio [HR] = 4.54; 95% confidence interval [CI], 1.13-18.15; p = 0.032).
  
  
  CONCLUSIONS
  The only independent predictor of PJI was early transfusion of packed RBCs stored &gt;14 days. Therefore, a potential way for reducing the PJI rate could be the selection of young packed RBCs.
authors.affiliation: Department of Orthopaedic Surgery, Hospital Clinic of Barcelona, Barcelona - Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Tornero
authors.affiliation: Service of Haemotherapy and Haemostasis, Hospital Clinic of Barcelona, Barcelona - Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Department of Orthopaedic Surgery, Hospital Clinic of Barcelona, Barcelona - Spain.
authors.forename: Jessica
authors.initials: J
authors.lastname: Bravo
authors.affiliation: Department of Orthopaedic Surgery, Hospital Clinic of Barcelona, Barcelona - Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Angulo
authors.affiliation: Department of Anaesthesia, Hospital Clinic of Barcelona, Barcelona - Spain.
authors.forename: Misericordia
authors.initials: M
authors.lastname: Basora
authors.affiliation: Department of Internal Medicine, University Hospital of Salamanca-IBSAL, Salamanca - Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Marcos
authors.affiliation: Service of Infectious Diseases, Hospital Clinic of Barcelona, Spain; IDIBAPS, University of Barcelona, Barcelona - Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Soriano
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000592:standards*; D014481:United States / Q000453:epidemiology