The impact of blood transfusion on the development of postoperative infections in colon cancer patients

The contribution of blood transfusions to the occurrence of postoperative infections has been prospectively evaluated in 161 consecutive colorectal cancer patients who were operated on at our Institution. On admission, sex, age, total iron binding capacity, measurement of serum albumin and hemoglobin concentration, assessment of immune response by skin test (DHR) and weight loss were evaluated along with the duration of surgery, intraoperative blood loss and disease staging (Astler and Coller). Thirty-one patients (19.4%) developed postoperative infection. Univariate analysis showed that these infections were significantly related to the amount of transfused blood (p<0.02), the duration of surgery (p<0.005) and intraoperative blood loss (p<0.05), while weight loss and DHR p=0.08) failed to reach statistical significance. Multiple logistic analysis showed that blood transfusions exerted an independent significant contribution to the occurrence of postoperative infection when more than 500 ml of blood have been given (odds ratio=6.5, p<0.05). The predictive effect of the other variables was not confirmed. In conclusion, the transfusion of more than 500 ml of blood constitutes an independent risk factor in the development of postoperative infection after colorectal cancer surgery.