Abstract:
BACKGROUND:Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. METHODS:In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. RESULTS:Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54-2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03-1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10-1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18-1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03-1.90, p = 0.03). CONCLUSIONS:In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Engele LJ,Straat M,van Rooijen IHM,de Vooght KMK,Cremer OL,Schultz MJ,Bos LDJ,Juffermans NP,MARS Consortium.doi
10.1186/s13613-016-0173-1subject
Has Abstractpub_date
2016-12-01 00:00:00pages
67issue
1issn
2110-5820pii
10.1186/s13613-016-0173-1journal_volume
6pub_type
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journal_title:Annals of intensive care
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2020-01-10 00:00:00
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更新日期:2018-03-27 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2011-09-23 00:00:00
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pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2014-07-03 00:00:00
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journal_title:Annals of intensive care
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更新日期:2018-01-10 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2019-05-14 00:00:00