Infection risk from blood transfusions
Friday July 31st, 2009
Blood transfusion can be risky for heart surgery patients, as it may increase the chance of infection, experts warned today.
Dr Mary Rogers of the University of Michigan, USA, and colleagues explain that transfusion practices for hospitalised patients are being re-evaluated, partly because of fears over patients receiving large quantities of stored blood.
The team looked at the outcomes of 24,789 patients who received coronary artery bypass graft surgery from 2003-6. Patients were followed for 30 days after discharge.
Donated blood use ranged from 73 to 100 per cent in women and 50 to 100 per cent in men, depending on the hospital.
Transfusion doubled the risk of infection and raised the risk of death 4.7-fold. It was also linked to a significantly higher rate of readmission.
In the journal BMC Medicine, the researchers report that transfusion-related infections included those of the genitourinary system, respiratory tract, bloodstream, digestive tract and skin, as well as infection with Clostridium difficile, "suggesting a system-wide immune response".
"For each one per cent increase in hospital transfusion rates, there was a 0.13 per cent increase in predicted infection rates," they calculated.
"Hospital variation in transfusion practices after coronary artery bypass grafting was considerable, indicating that quality efforts may be able to influence practice and improve outcomes," they conclude.
Dr Rogers commented: "Clearly, blood transfusions are vital in the treatment of some conditions. However, over the past several decades a body of evidence has accumulated that indicates various adverse effects in patients who receive transfusions, particularly with exposure to allogeneic blood."
Safety would improve if hospitals carefully reviewed their guidelines and adhered closely to them, she believes.
Rogers, M. A. M. et al. Hospital variation in transfusion and infection after cardiac surgery: a cohort study. BMC Medicine (in press)
Tags: Heart Health | MRSA & Hygiene | North America
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