Transfusion practice and complications after laparotomy – an observational analysis of a randomized clinical trial
Article first published online: 9 JUL 2012
© 2012 The Author(s). Vox Sanguinis © 2012 International Society of Blood Transfusion
Volume 103, Issue 4, pages 294–300, November 2012
How to Cite
Nielsen, K., Meyhoff, C. S., Johansson, P. I., Jorgensen, L. N., Rasmussen, L. S. and PROXI Trial Group (2012), Transfusion practice and complications after laparotomy – an observational analysis of a randomized clinical trial. Vox Sanguinis, 103: 294–300. doi: 10.1111/j.1423-0410.2012.01626.x
- Issue published online: 18 OCT 2012
- Article first published online: 9 JUL 2012
- Received: 16 January 2012, revised 17 May 2012, accepted 22 May 2012
- postoperative complication;
- red blood cell transfusion;
- surgical site infection;
- transfusion practice
Background Transfusion of allogeneic red blood cells (RBC) may be associated with side effects. This study aimed to assess whether an association could be detected between transfusion practice and the occurrence of complications after laparotomy.
Study design and methods This study is an observational analysis of data from a randomized trial in 1400 patients who underwent laparotomy. A subgroup of 224 transfused patients with an intraoperative blood loss ≥200 ml were included in the analysis. Logistic regression analysis was used to investigate risk factors for postoperative complications. The ratio of intraoperative RBC transfusion to blood loss was computed, and patients grouped by the median into a liberal transfusion practice (ratio equal to or above the median) and a restrictive transfusion practice group (ratio below the median).
Results Surgical site infection occurred in 27% of patients in the liberal group vs. 20% of patients in the restrictive group with an OR of 1·5 [95% CI: 0·8–2·9] (P = 0·18) and an OR of 1·2 [95% CI: 0·5–2·9] (P = 0·73) when adjusting for known confounding variables. Pneumonia occurred in 14% vs. 8% in the liberal and restrictive group, respectively (adjusted P = 0·07), and admission to the intensive care unit was 15% vs. 7%, respectively (adjusted P = 0·02), but no other significant differences were found.
Conclusion A liberal transfusion practice was not significantly associated with postoperative complications, but pneumonia tended to be more common in the liberal group, which was more often admitted to the intensive care unit.