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IMPACT OF AGE OF BLOOD ON NOSOCOMIAL INFECTIONS IN CRITICALLY-ILL PATIENTS
October 2008, Vol 134, No. 4_MeetingAbstracts Abstract: Slide Presentations | October 2008
IMPACT OF AGE OF BLOOD ON NOSOCOMIAL INFECTIONS IN CRITICALLY-ILL PATIENTS Raquel Nahra, MD*; Jean-Sebastien Rachoin, MD; Kreidy Mazen, MD; Sara Mathew, MD; Christa Schorr, RN; David Gerber, DO Cooper University Hospital, Camden, NJ Chest. 2008;134(4_MeetingAbstracts):s48003. doi:10.1378/chest.134.4_MeetingAbstracts.s48003
Abstract PURPOSE:It has been suggested that the age of PRBC is associated with worse clinical outcomes. We studied the impact of the age of PRBC on the incidence of nosocomial infections. METHODS:Retrospective study of all transfused patients admitted to an ICU from July 2003-September 2006 and entered in the Project IMPACT database. We examined the association between the age of PRBC and the development of nosocomial infections (line related, pneumonia, UTI, sepsis, shock, endocarditis). RESULTS:Of 613 transfused patients identified, 191 were excluded because of incomplete information leaving 422 for analysis. Patient age was (Median) 66y, ICU LOS 4.5d, Hospital LOS 17d, APACHEII score 18,. The average age of blood was 26 days. 11% of patients died. 57 patients developed nosocomial infection: 32 developed 1, 21 developed 2 and 4 developed 3. We performed analysis on: age of the first unit of blood (FI), age of the “oldest” unit of blood (OL), the average age of unit of blood (AV) and the outcome NOSO defined as the development of nosocomial infection. Patients who developed NOSO had a significantly higher OL (Median) (28.5d vs. 32d, p=0.02), and a significantly greater number of units of blood (2 vs. 3, p=0.024). We classified the three variables as ≤;28 days or ≥ 29 days. We found that higher OL was significant associated with Higher NOSO (OR 2.1 [1.2–3.9] p=0.01). We performed a logistic regression analysis, and after adjustments found no significant associations with mortality, but there was a significant positive association between OL and NOSO (p=0.001).When looking at the outcome “at least one infection,” a higher number of units of blood (>=5 units) was found to be an independent predictor (p=0.042). CONCLUSION:Our study found a clear association between duration of blood storage and incidence of nosocomial infection. The number of units of blood transfused was found to be an independent predictor of nosocomial infection. CLINICAL IMPLICATIONS:Prospective trials should address ideal storage duration of PRBC and specific transfusion guidelines.
DISCLOSURE:Raquel Nahra, No Financial Disclosure Information; No Product/Research Disclosure Information Tuesday, October 28, 2008 2:30 PM - 4:00 PM
IMPACT OF AGE OF BLOOD ON NOSOCOMIAL INFECTIONS IN CRITICALLY-ILL PATIENTS Raquel Nahra, MD*; Jean-Sebastien Rachoin, MD; Kreidy Mazen, MD; Sara Mathew, MD; Christa Schorr, RN; David Gerber, DO Cooper University Hospital, Camden, NJ Chest. 2008;134(4_MeetingAbstracts):s48003. doi:10.1378/chest.134.4_MeetingAbstracts.s48003
Abstract PURPOSE:It has been suggested that the age of PRBC is associated with worse clinical outcomes. We studied the impact of the age of PRBC on the incidence of nosocomial infections. METHODS:Retrospective study of all transfused patients admitted to an ICU from July 2003-September 2006 and entered in the Project IMPACT database. We examined the association between the age of PRBC and the development of nosocomial infections (line related, pneumonia, UTI, sepsis, shock, endocarditis). RESULTS:Of 613 transfused patients identified, 191 were excluded because of incomplete information leaving 422 for analysis. Patient age was (Median) 66y, ICU LOS 4.5d, Hospital LOS 17d, APACHEII score 18,. The average age of blood was 26 days. 11% of patients died. 57 patients developed nosocomial infection: 32 developed 1, 21 developed 2 and 4 developed 3. We performed analysis on: age of the first unit of blood (FI), age of the “oldest” unit of blood (OL), the average age of unit of blood (AV) and the outcome NOSO defined as the development of nosocomial infection. Patients who developed NOSO had a significantly higher OL (Median) (28.5d vs. 32d, p=0.02), and a significantly greater number of units of blood (2 vs. 3, p=0.024). We classified the three variables as ≤;28 days or ≥ 29 days. We found that higher OL was significant associated with Higher NOSO (OR 2.1 [1.2–3.9] p=0.01). We performed a logistic regression analysis, and after adjustments found no significant associations with mortality, but there was a significant positive association between OL and NOSO (p=0.001).When looking at the outcome “at least one infection,” a higher number of units of blood (>=5 units) was found to be an independent predictor (p=0.042). CONCLUSION:Our study found a clear association between duration of blood storage and incidence of nosocomial infection. The number of units of blood transfused was found to be an independent predictor of nosocomial infection. CLINICAL IMPLICATIONS:Prospective trials should address ideal storage duration of PRBC and specific transfusion guidelines.
DISCLOSURE:Raquel Nahra, No Financial Disclosure Information; No Product/Research Disclosure Information Tuesday, October 28, 2008 2:30 PM - 4:00 PM