Abstract
Objective: To examine the association between blood transfusion and bacterial infective complications after resection for colorectal adenocarcinoma.
Design: Retrospective cohort study.
Setting: District hospital; Norway.
Subjects: 446 consecutive patients having resection of colorectal adenocarcinoma.
Main outcome measures: Postoperative bacterial infective morbidity in hospital.
Results: 112 patients (25%) developed postoperative infections in hospital. Univariate analysis showed that the development of infection was significantly associated with increasing age (p ≥ 0.02), rectal compared with colonic cancer (p ≥ 0.002), preoperative radiotherapy (p ≥ 0.005), blood loss during operation (p ≥ 0.001), the extent of the primary tumour (T stage): T4 compared with T1-T3 (p ≥ 0.004), the presence of regional lymph node metastasis (N stage): N1-N3 compared with N0 (p ≥ 0.01), operating surgeon 1 (p ≥ 0.009), operating surgeon 2 (p ≥ 0.03), and blood transfusion (p < 0.001). Multivariate logistic regression analysis showed that the following variables were independent predictors of infection: age, rectal compared with colonic cancer, T stage, N stage, and blood transfusion. The corrected odds ratios for infection were 1.5 (95% CI 0.8 to 2.8) when 1-3 units of blood were given and 3.1 (95% CI 1.6 to 6.0) when more than three units were given. Storage time did not affect the rate of postoperative infections in patients given transfusions.
Conclusion: Transfusion of non-filtered stored allogeneic blood suspended in saline-adenine-glucose-mannitol is an independent risk factor for the development of postoperative infections in hospital in patients having a resection of colorectal cancer.