Blood transfusion and infectious complications following colorectal cancer surgery

Blood transfusion has been linked to clinical phenomena attributable to immune suppression. We prospectively studied the relationship between perioperative blood transfusion and postoperative infectious complications in 343 consecutive patients undergoing surgery for colorectal cancer. Of the 134 patients who received transfusions 33 (24.6 per cent) developed infectious complications compared with 9 (4.3 per cent) of the 209 patients who did not receive blood (P less than 0.0001). The mean number of units of blood received by patients who developed infectious complications significantly exceeded the number for patients without infectious complications (2.31 versus 0.74, P less than 0.0001). The association of transfusion with infections was highly significant (P less than 0.0001) after controlling for age, sex, blood loss, procedure, tumour differentiation, stage, admission haematocrit, duration of surgery, length of the specimen and tumour size. Blood transfusion appears to be an independent risk factor for postoperative infectious complications.