1185 - Association Between Blood Product Transfusion and Development of Hospital Acquired Infections or Mortality in Patients Admitted to the Hospital Wards. A Retrospective Case-Control Study

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Presenting Author(s)

Arunmozhi S. Aravagiri

Resident Physician
HCA Healthcare, Nashville, TN;Riverside Community Hospital, Riverside, CA; University of California, Riverside, CA
Riverside, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

AN

Ayutyanont Napatkamon

Division Director of Research GME Far West Division
HCA Healthcare, Nashville, TN;Riverside Community Hospital, Riverside, CA; University of California, Riverside, CA
Riverside, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SS

Sabhyata Sharma

Resident Physician
HCA Healthcare, Nashville, TN;Riverside Community Hospital, Riverside, CA; University of California, Riverside, CA
Riverside, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TC

Timothy Collins

Resident Physician
HCA Healthcare, Nashville, TN;Riverside Community Hospital, Riverside, CA; University of California, Riverside, CA
Riverside, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CU

Chimezie Ubbaonu

Internal Medicine Teaching Hospitalist
HCA Healthcare, Nashville, TN;Riverside Community Hospital, Riverside, CA; University of California, Riverside, CA
Riverside, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HM

Hoveda Mufti

Internal Medicine Teaching Hospitalist
HCA Healthcare, Nashville, TN;Riverside Community Hospital, Riverside, CA; University of California, Riverside, CA
Riverside, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Transfusion of blood products has been shown to be associated with increased mortality and risk of infections in critically ill patients and following cardiac surgery [1-2]. However, there is scarce data evaluating this association in patients admitted to hospital wards. Here we seek to see if transfusion of blood products carries the same risk of infection and mortality in more stable patients.

Methods: This was a retrospective case-control study of patients admitted to the internal medicine wards who received packed red blood cells (PRBC), fresh frozen plasma (FFP) or platelet transfusions, using data from the HCA Healthcare administrative database from 2016 to 2019. Patients admitted with an infection, on steroids or other immunosuppressant medications were excluded. ICD-10 codes at discharge were used to determine hospital acquired infections (HAI). The presence of HAI was the dependent variable. A multivariable logistic regression was used to determine the effects of the independent variables on development of HAI after adjusting for age and Carlson’s Comorbidity Index. Odds ratios and 95% confidence intervals were calculated. Primary outcome of study was presence of HAI, while secondary outcome was mortality in transfused vs. non-transfused patients.

Results: A total of 1952 subjects were included in the study analysis. Of these, 653 or 33.4% had a HAI during their admission. Adjusted multivariable model showed transfusion of PRBC (OR 1.14, 95%CI 0.85-1.52), platelets (OR 1.41, 95% CI 0.93-2.10) or FFP (OR 1.27 95%CI 0.90-1.75) was not associated with increased odds of having a HAI. The multivariable model however, did show an increase in odds of mortality in patients who were transfused with PRBC (OR 2.51, 95%CI 1.78-3.54), platelets (OR 3.17, 95%CI 2.01-5.0) or FFP (OR 2.78, 95% CI 1.89-4.08) compared to non-transfused.

Conclusion: Our data failed to show association between transfusion of blood products and HAI. However, it showed there was significant increase in mortality in patients that had received blood products during their admission.