PMID- 35338708 OWN - NLM STAT- MEDLINE DCOM- 20220510 LR - 20220616 IS - 1537-2995 (Electronic) IS - 0041-1132 (Linking) VI - 62 IP - 5 DP - 2022 May TI - Allogeneic blood transfusions and infection risk in lumbar spine surgery: An American College of Surgeons National Surgery Quality Improvement Program Study. PG - 1027-1033 LID - 10.1111/trf.16864 [doi] AB - BACKGROUND: Allogenic blood transfusions can lead to immunomodulation. Our purpose was to investigate whether perioperative transfusions were associated with postoperative infections and any other adverse events (AEs), after adjusting for potential confounding factors, following common elective lumbar spinal surgery procedures. STUDY DESIGN AND METHODS: We performed a multivariate, propensity-score matched, regression-adjusted retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database between 2012 and 2016. All lumbar spinal surgery procedures were identified (n = 174,891). A transfusion group (perioperative transfusion within 72 h before, during, or after principal surgery; n = 1992) and a control group (no transfusion; n = 1992) were formed. Following adjustment for between-group baseline features, adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were calculated using a multivariate logistic regression model for any surgical site infection (SSI), superficial SSI, deep SSI, wound dehiscence, pneumonia, urinary tract infection, sepsis, any infection, mortality, and any AEs. RESULTS: Transfusion was associated with an increased risk of each specific infection, mortality, and any AEs. Statistically significant between-group differences were demonstrated with respect to any SSI (aOR: 1.48; 95% CI: 1.01-2.16), deep SSI (aOR: 1.66; 95% CI: 0.98-2.85), sepsis (aOR: 2.69; 95% CI: 1.43-5.03), wound dehiscence (aOR: 2.27; 95% CI: 0.86-6.01), any infection (aOR: 1.46; 95% CI: 1.13-1.88), any AEs (aOR: 1.80; 95% CI: 1.48-2.18), and mortality (aOR: 2.17; 95% CI: 0.77-6.36). CONCLUSION: We showed an association between transfusion and infection in lumbar spine surgery after adjustment for various applicable covariates. Sepsis had the highest association with transfusion. Our results reinforce a growing trend toward minimizing perioperative transfusions, which may lead to reduced infections following lumbar spine surgery. CI - (c) 2022 AABB. FAU - Falsetto, Amedeo AU - Falsetto A AD - Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. FAU - Roffey, Darren M AU - Roffey DM AUID- ORCID: 0000-0001-6570-3290 AD - uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ontario, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. FAU - Jabri, Hussam AU - Jabri H AD - Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. AD - uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ontario, Canada. AD - Division of Neurosurgery, The Ottawa Hospital, Ottawa, Ontario, Canada. FAU - Kingwell, Stephen P AU - Kingwell SP AD - Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. AD - uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ontario, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. AD - Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada. FAU - Stratton, Alexandra AU - Stratton A AD - Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. AD - uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ontario, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. AD - Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada. FAU - Phan, Philippe AU - Phan P AD - Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. AD - uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ontario, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. AD - Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada. FAU - Wai, Eugene K AU - Wai EK AD - Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. AD - uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ontario, Canada. AD - Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. AD - Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada. LA - eng PT - Journal Article DEP - 20220326 PL - United States TA - Transfusion JT - Transfusion JID - 0417360 SB - IM MH - Blood Transfusion MH - Disease Susceptibility/complications MH - *Hematopoietic Stem Cell Transplantation/adverse effects MH - Humans MH - Postoperative Complications/epidemiology/etiology MH - Quality Improvement MH - Retrospective Studies MH - Risk Factors MH - *Sepsis/complications MH - *Surgeons MH - Surgical Wound Infection/complications/etiology OTO - NOTNLM OT - NSQIP OT - adverse events OT - blood transfusion OT - immunosuppression OT - infection OT - logistic regression OT - mortality OT - multivariate OT - odds ratio OT - surgical site infection EDAT- 2022/03/27 06:00 MHDA- 2022/05/11 06:00 CRDT- 2022/03/26 12:02 PHST- 2022/01/29 00:00 [revised] PHST- 2020/12/16 00:00 [received] PHST- 2022/02/27 00:00 [accepted] PHST- 2022/03/27 06:00 [pubmed] PHST- 2022/05/11 06:00 [medline] PHST- 2022/03/26 12:02 [entrez] AID - 10.1111/trf.16864 [doi] PST - ppublish SO - Transfusion. 2022 May;62(5):1027-1033. doi: 10.1111/trf.16864. Epub 2022 Mar 26.