Allogeneic blood transfusions and postoperative infections after lumbar spine surgery

Abstract Background context Allogeneic blood transfusions have an immunomodulating effect, and the previous studies in other fields of medicine demonstrated an increased risk of infections after administration of allogeneic blood transfusions. Purpose Our primary null hypothesis is that exposure to...

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Bibliographic Details
Published in:The spine journal 2015-05, Vol.15 (5), p.901-909
Main Authors: Janssen, Stein J., MD, Braun, Yvonne, MD, Wood, Kirkham B., MD, Cha, Thomas D., MD, MBA, Schwab, Joseph H., MD, MS
Format: Article
Language:English
Subjects:
Adult
Aged
Cohort Studies
Female
Guideline
Humans
Immunomodulation
Infection
Lumbar
Lumbar Vertebrae - surgery
Male
Middle Aged
Neurosurgical Procedures - adverse effects
Orthopedics
Policy
Retrospective Studies
Sepsis - epidemiology
Sepsis - etiology
Surgery
Surgical Wound Infection - epidemiology
Surgical Wound Infection - etiology
Transfusion
Transfusion Reaction
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Summary:Abstract Background context Allogeneic blood transfusions have an immunomodulating effect, and the previous studies in other fields of medicine demonstrated an increased risk of infections after administration of allogeneic blood transfusions. Purpose Our primary null hypothesis is that exposure to allogeneic blood transfusion in patients undergoing lumbar spine surgery is not associated with postoperative infections after controlling for patient and treatment characteristics. Second, we assessed if there was a dose-response relationship per unit of blood transfused. Study design/Setting This is a retrospective cohort study from a tertiary care spine referral center. Patient Sample A total of 3,721 patients underwent laminectomy and/or arthrodesis of the lumbar spine. Outcomes measures Postoperative infections, pneumonia, endocarditis, meningitis, urinary tract infection, central venous line infection, surgical site infection, and sepsis, within 90 days after lumbar spine surgery were included. Methods Multivariable logistic regression analyses were used to assess the relationship of perioperative allogeneic blood transfusion with specific and overall postoperative infections accounting for age, duration of surgery, duration of hospital stay, comorbidity status, preoperative hemoglobin, sex, type of operation, multilevel treatment, operative approach, and year of surgery. Results The adjusted odds ratio for exposure to allogeneic blood transfusion from multivariable logistic regression analysis was 2.6 for any postoperative infection (95% confidence interval [CI]: 1.7–3.9, p
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2015.02.010