Relationship between perioperative blood transfusion and surgical site infections in the newborn population: An ACS-NSQIP-Pediatrics analysis.
BACKGROUND
Adult data suggest that perioperative transfusion may have deleterious effects through immunomodulation. Limited data regarding the effect of transfusions exist in the pediatric population. We hypothesized that perioperative transfusions may be associated with surgical site infections (SSI) in newborns.


METHODS
The 2012 and 2013 American College of Surgeons National Safety and Quality Improvement Project-Pediatric (ACS-NSQIP-P) Participant User Files were queried to include all neonates that underwent surgical procedures. SSI rates in infants who had a perioperative blood transfusion were compared to those who were not transfused using a Fisher's Exact Test. Logistic regression analysis compared the odds of SSIs in transfused patients versus nontransfused patients. p Values <0.05 were statistically significant.


RESULTS
The study population included 6499 patients, of which 1109 (17.1%) had transfusions. Transfused patients had increased SSIs. In the multivariate analysis, patients with nutritional issues (OR=1.58, 95%CI 1.24-2.00), current infection (OR=1.98, 95%CI 1.52-2.57), and perioperative transfusion (OR=2.08, 95%CI 1.59-2.72) were associated with increased risk of SSI after controlling for all other variables.


CONCLUSIONS
Perioperative transfusions are associated with increased risk of SSIs. Further work to determine possible mechanisms of this association may be warranted.
Loma Linda University, 11175 Campus Street, #21108, Loma Linda, CA, USA.
Jason
J
Fawley
Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA.
Thomas H
TH
Chelius
Children's Hospital of Wisconsin, 999 N 92nd Street Suite 320, Milwaukee, WI, USA.
Yvonne
Y
Anderson
Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA.
Laura D
LD
Cassidy
Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA; Children's Hospital of Wisconsin, 999 N 92nd Street Suite 320, Milwaukee, WI, USA. Electronic address: MArca@chw.org.
Marjorie J
MJ
Arca
D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D019990:Perioperative Care / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D065227:Transfusion Reaction; D014481:United States / Q000453:epidemiology
NSQIP; Newborn; Surgical site infections; Transfusion