BLOOD-TRANSFUSION AND SEPTIC COMPLICATIONS AFTER HIP-REPLACEMENT SURGERY

Background: The purpose of this study was to address some methodologic issues that might help explain the disagreement between the findings of earlier reports on the presumed association between allogeneic bloo d transfusion and the increased postoperative infection rates seen in orthopedic surgery patients. Study Design and Methods: A retrospective review of the incidence of postoperative septic complications in 367 patients from Olmsted County, Minnesota, who underwent 420 elective to tal hip arthroplasties between 1986 and 1993, was conducted. The infec tion rates in the exposed patients (those who had perioperatively rece ived allogeneic blood components only or allogeneic and autologous blo od components) were compared with those in the untransfused patients a nd patients who received only autologous blood. The study had sufficie nt statistical power to detect a deleterious effect of allogeneic bloo d transfusion equal to the 2.8-fold effect observed in a recent random ized clinical trial of patients undergoing elective abdominal surgery. Results: There was no association of allogeneic blood transfusion wit h postoperative infection (p = 0.226). Nineteen infections occurred in 201 exposed patients (9.5%), as compared to 14 infections in 219 unex posed patients (6.4%). Conclusion: Allogeneic blood transfusion does n ot increase the incidence of postoperative septic complications in pat ients undergoing elective total hip arthroplasty, at least to the exte nt that the statistical power of this study allowed the determination.