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Ann Thorac Surg 2004;78:1542-1546
© 2004 The Society of Thoracic Surgeons

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Original article: cardiovascular

Allogenic Blood Transfusion Does Not Predispose to Infection After Cardiac Surgery

^a Department of Cardiothoracic Surgery, Papworth Hospital, Papworth Everard, Cambridge, United Kingdom
^b Department of Cardiothoracic Anaesthesia, Papworth Hospital, Papworth Everard, Cambridge, United Kingdom
^c Department of Microbiology, Papworth Hospital, Papworth Everard, Cambridge, United Kingdom

Accepted for publication May 7, 2004.

^* Address reprint requests to Dr Lim, Department of Cardiothoracic Surgery, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE, UK
eric.lim{at}cvsnet.org

BACKGROUND: Many retrospective studies report increased postoperative infection after allogenic blood transfusion. To investigate this phenomenon, we prospectively studied 232 patients undergoing cardiac surgery.

METHODS: Patients were screened daily for evidence of culture positive infections. Wounds were examined daily and defined on the ASEPSIS score. Chest radiographs and white cell counts and differentials were recorded on days 1, 2, and 4. The use of blood products was monitored blindly and independently. Patients were grouped according to transfusion status and compared using ² or Fisher's test. Logistic regression analyses were performed to identify predictors of transfusion and infection.

RESULTS: Of 232 patients, 116 (50%) received blood product transfusion. Patients receiving blood had lower preoperative hemoglobin, were older, with a greater proportion of urgent/emergency or revision surgery, and were higher risk. Despite this, there were no differences in the frequency of chest infection (20% versus 15%, p = 0.38), urinary infection (3.5% versus 5.3%, p = 0 0.75), wound infection (3.5% versus 8.0%, p = 0.16), or overall infection (28% versus 30%, p = 0.89) comparing the transfused versus untransfused groups. There was no evidence to suggest that administration of blood products was associated with infection (odds ratio 0.92, p = 0.77).

CONCLUSIONS: The administration of blood per se did not lead to increased postoperative infection. Clinicians should reconsider withholding blood transfusion in patients solely owing to concerns of predisposition to infection.

This article has been cited by other articles:

				G. J. Murphy and G. D. Angelini Indications for Blood Transfusion in Cardiac Surgery Ann. Thorac. Surg., December 1, 2006; 82(6): 2323 - 2334. [Abstract] [Full Text] [PDF]

				A. Michalopoulos, S. Geroulanos, E. S. Rosmarakis, and M. E. Falagas Frequency, characteristics, and predictors of microbiologically documented nosocomial infections after cardiac surgery. Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 456 - 460. [Abstract] [Full Text] [PDF]