Background:
Previous observations suggest that intraoperative blood transfusion (ibt) is a risk factor for adverse postoperative outcomes. ibt alters immune function and may predispose to systemic inflammatory response syndrome (sirs).
Methods:
Patients in the american college of surgeons national surgical quality improvement project database were studied over a 5-year period. logistic regression identified predictors of sirs. propensity matching was used to obtain a balanced set of patients with equivalent preoperative risks for ibt.
Results:
Of 553,288 inpatients, 19,968 (3.6%) developed postoperative sirs, and 40,378 (7.2%) received ibt. mortality in patients with sirs was 13-fold higher than in those without sirs (13.5% vs 1.0%, p < .001). multivariate analysis identified the amount of blood transfused during ibt as a significant predictor for development of sirs (odds ratio, 2.2; p < .0001). after propensity matching, 33,507 matched patients with ibt had significantly increased risk for sirs compared with non-sirs matched patients (12.0% vs 6.5%, p < .001).
Conclusions:
There is a significant association between ibt and the development of sirs. ibt may induce sirs, and reductions in ibt may decrease the incidence of postoperative sirs.