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Infection after injury: association with blood transfusion
A S Rosemurgy1, M B Hart, C G Murphy
1Department of Surgery, University of South Florida, Tampa 33606.
The American Surgeon
|February 1, 1992
Summary
This study found that trauma patients receiving 7 or more units of red blood cells (RBCs) had a higher risk of infection. The risk increased with more RBC transfusions, suggesting a dose-related effect.
Area of Science:
- Trauma care
- Transfusion medicine
- Infectious disease epidemiology
Background:
- Red blood cell (RBC) transfusions are common in trauma resuscitation.
- The association between RBC transfusion volume and post-injury infection risk requires further investigation.
Purpose of the Study:
- To evaluate the association between red blood cell transfusions and infection risk in injured adults.
- To determine if transfusion volume impacts infection rates in trauma patients.
Main Methods:
- Retrospective analysis of 390 trauma patients receiving type "O" RBCs during initial resuscitation.
- Patients were stratified based on receiving 6 or fewer vs. 7 or more units of RBCs.
- Statistical adjustments were made for age, sex, and injury severity scores (Champion Trauma Score, Injury Severity Score, TRISS).
Main Results:
- A higher risk of infection was observed in patients receiving 7 or more units of RBCs.
- Infection risk demonstrated a dose-related association with the number of RBC units transfused.
- Mortality within 7 days was 39% (154 patients), while 61% (236 patients) survived beyond 7 days.
Conclusions:
- Higher volumes of red blood cell transfusions are associated with an increased risk of infection in trauma patients.
- Transfusion guidelines should consider avoiding unnecessary transfusions and reconsidering arbitrary "trigger points".
- Minimizing RBC transfusions may be crucial for reducing infection complications in severely injured adults.