Peri-operative blood transfusion and risk of infectious complications following intestinal-cutaneous fistula surgical repair: A retrospective nationwide analysis
Alser O., Christensen MA., Saillant N., Parks J., Mendoza A., Fagenholz P., King D., Kaafarani HMA., Velmahos GC., Fawley J.
Background: Peri-operative blood transfusion (BT) may lead to transfusion-induced immunomodulation. We aimed to investigate the association between peri-operative BT and infectious complications in patients undergoing intestinal-cutaneous fistulas (ICF) repair. Methods: We queried the ACS-NSQIP 2006–2017 database to include patients who underwent ICF repair. The main outcome was 30-day infectious complications. Univariate and multivariable logistic regression analyses were performed to assess the predictors of post-operative infections. Results: Of 4,197 patients included, 846 (20.2%) received peri-operative BT. Transfused patients were generally older, sicker and had higher ASA (III–V). After adjusting for relevant covariates, patients who received intra and/or post-operative (and not pre-operative) BT had higher odds of infectious complications compared (OR = 1.22, 95% CI 1.01–1.48). Specifically, they had higher odds of organ-space surgical site infection (OR = 1.61, 95% CI 1.21–2.13), but not other infectious complications. Conclusions: Intra and/or post-operative (and not pre-operative) BT is an independent predictor of infectious complications in ICF repair.