Timing and Incidence of Postoperative Infections Associated with Blood Transfusion: Analysis of 1,489 Orthopedic and Cardiac Surgery Patients

Abstract

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. 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. 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). Patients should be followed for as long as four weeks after discharge to determine the true incidence and risk of ABT-associated PI.