Background:We have previously demonstrated that blood transfusion(BT)was associated with post-operative complications in patients undergoing surgery for Crohn’s disease(CD),based on our institutional data registry.Th...Background:We have previously demonstrated that blood transfusion(BT)was associated with post-operative complications in patients undergoing surgery for Crohn’s disease(CD),based on our institutional data registry.The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program(ACS NSQIP)database.Methods:All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP.Variables were defined according to the ACS NSQIP guidelines.The primary outcome was infectious complications,including superficial,deep and organ/space surgical site infection,wound dehiscence,urinary tract infection,pneumonia,systemic sepsis and septic shock.Multivariate analyses were performed to assess the risk factors for post-operative infections.Results:All 10100 eligible patients were included and 611(6.0%)received perioperative BT.BT patients were older,lighter in weight and more likely to be functionally dependent.BT patients were more likely to have post-operative infectious complications than those without BT,including superficial surgical site infection(SSI)(10.8%vs 7.4%,p¼0.002),deep SSI(3.3%vs 1.6%,p¼0.003),organ/space SSI(14.2%vs 5.4%,p<0.001),pneumonia(3.8%vs 1.3%,p<0.001),urinary tract infection(3.9%vs 2.2%,p¼0.006),sepsis(11.5%vs 4.5%,p<0.001)and sepsis shock(3.1%vs 0.8%,p<0.001).Multivariate analysis showed that intra-and/or post-operative BT was an independent risk factor for post-operative infectious complications(odds ratio[OR]¼2.2;95%confidence interval[CI]:1.8–2.7;p<0.001)and the risk increased with each administered unit of red blood cell(OR¼1.3,95%CI:1.2–1.5).Other independent factors were history of smoking,chronic heart disease,diabetes,hypertension and the use of corticosteroids.Pre-operative BT,however,was not found to be a risk factor to post-operative infections.Conclusions:Intra-and/or post-operative,not pre-operative,BT was found to be associated with an increased risk for postoperative infectious complications in this CD cohort.Therefore,the timing and risks and benefits of BT should be carefully balanced.展开更多
目的探讨不同时期招募的献血人群传播输血性感染(transfus ion-transm itted in fections,TT Is)的风险。方法以血液筛查合格率和血清感染标志物(in fectious d isease m arkers,IDM s)HB sA g、抗-HCV、抗-H IV和梅毒的检出率作为评价...目的探讨不同时期招募的献血人群传播输血性感染(transfus ion-transm itted in fections,TT Is)的风险。方法以血液筛查合格率和血清感染标志物(in fectious d isease m arkers,IDM s)HB sA g、抗-HCV、抗-H IV和梅毒的检出率作为评价依据。结果招募的献血人群血液筛查合格率依次为早期有偿人群82.6%、早期无偿人群89.4%、定期有偿人群93.5%和近期无偿人群9 4.8%,人均年献血小板2.8次者抗-HCV血清阳性率为0.1 1 0%、HB sA g为0.0 5 7%、梅毒为0.038%,未有H IV感染者的定期无偿机采人群。结论招募的定期无偿机采人群显示出低IDM s水平的特征,属于低风险人群。展开更多
文摘Background:We have previously demonstrated that blood transfusion(BT)was associated with post-operative complications in patients undergoing surgery for Crohn’s disease(CD),based on our institutional data registry.The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program(ACS NSQIP)database.Methods:All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP.Variables were defined according to the ACS NSQIP guidelines.The primary outcome was infectious complications,including superficial,deep and organ/space surgical site infection,wound dehiscence,urinary tract infection,pneumonia,systemic sepsis and septic shock.Multivariate analyses were performed to assess the risk factors for post-operative infections.Results:All 10100 eligible patients were included and 611(6.0%)received perioperative BT.BT patients were older,lighter in weight and more likely to be functionally dependent.BT patients were more likely to have post-operative infectious complications than those without BT,including superficial surgical site infection(SSI)(10.8%vs 7.4%,p¼0.002),deep SSI(3.3%vs 1.6%,p¼0.003),organ/space SSI(14.2%vs 5.4%,p<0.001),pneumonia(3.8%vs 1.3%,p<0.001),urinary tract infection(3.9%vs 2.2%,p¼0.006),sepsis(11.5%vs 4.5%,p<0.001)and sepsis shock(3.1%vs 0.8%,p<0.001).Multivariate analysis showed that intra-and/or post-operative BT was an independent risk factor for post-operative infectious complications(odds ratio[OR]¼2.2;95%confidence interval[CI]:1.8–2.7;p<0.001)and the risk increased with each administered unit of red blood cell(OR¼1.3,95%CI:1.2–1.5).Other independent factors were history of smoking,chronic heart disease,diabetes,hypertension and the use of corticosteroids.Pre-operative BT,however,was not found to be a risk factor to post-operative infections.Conclusions:Intra-and/or post-operative,not pre-operative,BT was found to be associated with an increased risk for postoperative infectious complications in this CD cohort.Therefore,the timing and risks and benefits of BT should be carefully balanced.
文摘目的探讨不同时期招募的献血人群传播输血性感染(transfus ion-transm itted in fections,TT Is)的风险。方法以血液筛查合格率和血清感染标志物(in fectious d isease m arkers,IDM s)HB sA g、抗-HCV、抗-H IV和梅毒的检出率作为评价依据。结果招募的献血人群血液筛查合格率依次为早期有偿人群82.6%、早期无偿人群89.4%、定期有偿人群93.5%和近期无偿人群9 4.8%,人均年献血小板2.8次者抗-HCV血清阳性率为0.1 1 0%、HB sA g为0.0 5 7%、梅毒为0.038%,未有H IV感染者的定期无偿机采人群。结论招募的定期无偿机采人群显示出低IDM s水平的特征,属于低风险人群。
