Packed red blood cells increased infection risk after cardiac surgery

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Packed red blood cells increased infection risk after cardiac surgery

Patients with packed red blood cells had an increased risk for major infection after cardiac surgery, according to study results presented at The Society of Thoracic Surgeons 48th Annual Meeting.

Researchers enrolled 5,184 adult patients (mean age, 64.4 years) to assess major and minor infections based on CDC/National Healthcare Safety Network definitions experienced after cardiac surgery. An independent committee of infectious disease experts adjudicated all infections. Isolated CABG (31%; n=1,597) and isolated valve (30%; n=1,549) with a mean bypass time of 115.4 minutes were the most common procedures, and 1.4% were reoperations. Mean baseline hemoglobin was 13.2 mg/dL.
Risk for infection was associated with packed red blood cells and platelets, according to study results. Packed red blood cells were transfused in 48% (n=2,491; mean 4.1 units) of patients, and platelets were transfused in 31% (n=1,610; mean 5.9 units) of patients. Among those receiving platelet transfusions, pneumonia (3.7%) and bloodstream infections (2%) were the most common infections.
Using multivariable logistic regression and Cox modeling, researchers also found a dose-dependent association between quantities of packed red blood cells and risk for infection. Study results showed that the crude risk increased by 31% with each packed red blood cell unit (P<.001). However, the risk for infection decreased with platelet transfusion. After adjusting for overall risk for infection, researchers found risk for death was 3.2 times higher and risk for an additional day of hospital stay was 1.32 times higher.
“Efforts to reduce packed red blood cell transfusions may significantly reduce the incidence of major post-operative infections,” researchers concluded.

For more information:

• Horvath KA. Do blood transfusions affect the risk of infections after cardiac surgery? Experience of the NIH/CIHR Cardiothoracic Surgical Trials Network. Presented at: The Society of Thoracic Surgeons 48th Annual Meeting; Jan. 28-Feb. 1, 2012; Fort Lauderdale, Fla.
  

Disclosure: The researchers report no relevant financial disclosures.

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盒装的红血细胞的心脏手术后感染的风险增加

心脏手术后的浓缩红细胞的患者为主要感染的风险增加，根据研究结果在胸外科医师学会第48届年会。

研究人员招收5184成年患者（平均年龄64.4岁），以评估疾病预防控制中心/国家医疗保健安全网定义经历了心脏手术后的主要和次要的感染。一个独立的传染病专家委员会裁定所有的感染。孤立的冠状动脉搭桥术（31％; N =1597）和隔离阀（30％，N=1549）的115.4分钟，平均体外循环时间是最常见的程序，和1.4％，再次手术。平均基线血红蛋白为13.2毫克/升。
感染的风险与包装的红血细胞和血小板，根据研究结果。浓缩红细胞输血在48％（N =2491;平均4.1单位），患者和血小板在31％的输血（N =1,610，平均5.9单位）的患者。在接受血小板输注，肺炎（3.7％）和血液感染（2％）是最常见的感染。
使用多变量logistic回归和Cox模型，研究人员还发现了一个包装的红血细胞和感染的风险的数量之间的剂量依赖性的关联。研究结果表明，原油的风险增加了31％，每个包装的红血细胞单位（P <0.001）。然而，感染的风险，减少血小板输注。感染的整体风险进行调整后，研究人员发现，死亡的风险是一个额外的住院日高出1.32倍3.2倍和风险。