DOES BLOOD-TRANSFUSION INCREASE THE RISK OF INFECTION AFTER HIP FRACTURE

Objective: To determine whether allogeneic red blood cell transfusion is a predictor for developing an in-hospital postoperative urinary tra ct, respiratory, or wound infection. Study Design: Prospective, consec utive. Methods: Six hundred eighty-seven community-dwelling, ambulator y, geriatric hip fracture patients were prospectively followed; all pa tients had operative fracture treatment and received perioperative ant ibiotics. Results: Sixty-eight patients had a culture-positive infecti on before operative treatment. One hundred thirty-four of the remainin g 619 patients (21.6%) developed a postoperative infection, primarily a urinary tract infection. The infection rate was 26.8% in transfused patients compared with 14.9% in nontransfused patients (p = 0.001). Wh en stratifying by the type of infection, only the risk of urinary trac t infection was statistically significant (p = 0.001). After controlli ng for the effect of patient age, sex, number of preinjury medical com orbidities, American Society of Anesthesiologists (ASA) rating of oper ative risk, fracture type, surgical delay, type of surgery, type of an esthesia, operative time, and blood loss, the relationship between all ogeneic red blood cell transfusion and postoperative urinal tract infe ction remained statistically significant. Conclusions: Geriatric hip f racture patients who receive allogeneic red blood cell transfusions ar e at higher risk for developing a postoperative urinary tract infectio n than are those patients who are not transfused.