Blood transfusion increases the risk of infection after trauma

N. Agarwal, J. G. Murphy, C. G. Cayten and W. M. Stahl
Institute for Trauma and Emergency Care, New York Medical College, Valhalla.

To determine whether blood transfusion influences infection after trauma, we analyzed data on 5366 consecutive patients hospitalized for more than 2 days at eight hospitals over a 2-year period. The incidence of infection was significantly related to the mechanism of injury: penetrating injuries, 8.9%; blunt injuries, 12.9%; and low falls, 21.4%. Stepwise logistic regression analyses of infection using the variables age, sex, respiration rate in the emergency department, Glasgow Coma Scale in the emergency department, Injury Severity Score, shock (systolic blood pressure < 90 mm Hg on admission to the emergency department), and log of total amount of blood transfused during hospitalization showed that amount of blood received and Injury Severity Score were the only two variables that were significant predictors of infection across groups. Even when patients were stratified by Injury Severity Score, the infection rate increased significantly with increases in numbers of units of blood. Blood transfusion in the injured patients is an important independent statistical predictor of infection. Its contribution cannot be attributed to age, sex, or the underlying mechanism of severity of injury.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Natural resistance, iron and infection: a challenge for clinical medicine.
Bullen et al.
J Med Microbiol 2006;55:251-258.
ABSTRACT | FULL TEXT  

Transfusion Practice and Blood Stream Infections in Critically Ill Patients
Shorr et al.
Chest 2005;127:1722-1728.
ABSTRACT | FULL TEXT  

Fluid choice for resuscitation of the trauma patient: a review of the physiological, pharmacological, and clinical evidence: [Le choix du liquide pour la reanimation du patient polytraumatise : une revue des donnees physiologiques, pharmacologiques et cliniques]
Boldt
Canadian J. Anesthesia 2004;51:500-513.
ABSTRACT | FULL TEXT  

Association of bacterial infection and red blood cell transfusion after coronary artery bypass surgery
Chelemer et al.
Ann. Thorac. Surg. 2002;73:138-142.
ABSTRACT | FULL TEXT  

Which fluid to give?
Protheroe and Nolan
Trauma 2001;3:151-160.
ABSTRACT  

The Good, the Bad, and the Ugly: Should We Completely Banish Human Albumin from Our Intensive Care Units?
Boldt
Anesth. Analg. 2000;91:887-895.
ABSTRACT | FULL TEXT  

Recombinant 21 kDa N-terminal fragment of human bactericidal/permeability-increasing protein (rBPI21): progress in the clinic
Scannon
Innate Immunity 1999;5:209-212.
ABSTRACT