ReviewBlood Transfusion and Infection After Cardiac Surgery
Section snippets
Study Design and Patients
This observational study of postoperative infections among adults undergoing cardiac surgery at 10 centers in the United States and Canada was funded by the National Institutes of Health and Canadian Institutes of Health Research. Its overall objective was to identify management practices associated with risk for infections. Inclusion criteria were a clinical indication for a cardiac surgical intervention and age 18 years or older. Patients with active systemic infection at enrollment (most
Infections After Cardiac Surgery
Overall, 5,158 patients experienced 298 major infections (5.8%). The most commonly occurring major infections were pneumonia, C difficile colitis, and bloodstream infections. Surgical site infections were uncommon (Table 2). More than 40% of major infections occurred after hospital discharge.
Prevalence of Transfusion
Overall, 2,481 patients (48%) received at least 1 unit RBC, with close to half of transfused patients receiving 1 or 2 units (48%). Although percentage of patients transfused ranged from 33% to 74%,
Principal Findings
This unique contemporary multiinstitutional study of infections occurring up to 65 days after a variety of cardiac surgical operations, with well-adjudicated events, revealed that RBC transfusion, particularly postoperative transfusion, was strongly associated with major postoperative infections in a dose-related fashion. Use of platelets appeared to have a mitigating effect, especially for patients receiving higher numbers of RBC units. The association between RBC transfusion and infection was
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