Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill

Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Engele, Leo J. [verfasserIn] Straat, Marleen [verfasserIn] van Rooijen, Ingeborg H. M. [verfasserIn] de Vooght, Karen M. K. [verfasserIn] Cremer, Olaf L. [verfasserIn] Schultz, Marcus J. [verfasserIn] Bos, Lieuwe D. J. [verfasserIn] Juffermans, Nicole P. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Nosocomial infection Critically ill Red blood cells Fresh-frozen plasma Platelets Transfusion

Übergeordnetes Werk:	Enthalten in: Annals of intensive care - Heidelberg : Springer, 2011, 6(2016), 1 vom: 19. Juli
Übergeordnetes Werk:	volume:6 ; year:2016 ; number:1 ; day:19 ; month:07

Links:	Volltext

DOI / URN:	10.1186/s13613-016-0173-1

Katalog-ID:	SPR031929265

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520			\|a Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection.
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allfields	10.1186/s13613-016-0173-1 doi (DE-627)SPR031929265 (SPR)s13613-016-0173-1-e DE-627 ger DE-627 rakwb eng 610 ASE Engele, Leo J. verfasserin aut Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection. Nosocomial infection (dpeaa)DE-He213 Critically ill (dpeaa)DE-He213 Red blood cells (dpeaa)DE-He213 Fresh-frozen plasma (dpeaa)DE-He213 Platelets (dpeaa)DE-He213 Transfusion (dpeaa)DE-He213 Straat, Marleen verfasserin aut van Rooijen, Ingeborg H. M. verfasserin aut de Vooght, Karen M. K. verfasserin aut Cremer, Olaf L. verfasserin aut Schultz, Marcus J. verfasserin aut Bos, Lieuwe D. J. verfasserin aut Juffermans, Nicole P. verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 6(2016), 1 vom: 19. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:6 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s13613-016-0173-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 1 19 07
spelling	10.1186/s13613-016-0173-1 doi (DE-627)SPR031929265 (SPR)s13613-016-0173-1-e DE-627 ger DE-627 rakwb eng 610 ASE Engele, Leo J. verfasserin aut Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection. Nosocomial infection (dpeaa)DE-He213 Critically ill (dpeaa)DE-He213 Red blood cells (dpeaa)DE-He213 Fresh-frozen plasma (dpeaa)DE-He213 Platelets (dpeaa)DE-He213 Transfusion (dpeaa)DE-He213 Straat, Marleen verfasserin aut van Rooijen, Ingeborg H. M. verfasserin aut de Vooght, Karen M. K. verfasserin aut Cremer, Olaf L. verfasserin aut Schultz, Marcus J. verfasserin aut Bos, Lieuwe D. J. verfasserin aut Juffermans, Nicole P. verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 6(2016), 1 vom: 19. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:6 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s13613-016-0173-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 1 19 07
allfields_unstemmed	10.1186/s13613-016-0173-1 doi (DE-627)SPR031929265 (SPR)s13613-016-0173-1-e DE-627 ger DE-627 rakwb eng 610 ASE Engele, Leo J. verfasserin aut Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection. Nosocomial infection (dpeaa)DE-He213 Critically ill (dpeaa)DE-He213 Red blood cells (dpeaa)DE-He213 Fresh-frozen plasma (dpeaa)DE-He213 Platelets (dpeaa)DE-He213 Transfusion (dpeaa)DE-He213 Straat, Marleen verfasserin aut van Rooijen, Ingeborg H. M. verfasserin aut de Vooght, Karen M. K. verfasserin aut Cremer, Olaf L. verfasserin aut Schultz, Marcus J. verfasserin aut Bos, Lieuwe D. J. verfasserin aut Juffermans, Nicole P. verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 6(2016), 1 vom: 19. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:6 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s13613-016-0173-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 1 19 07
allfieldsGer	10.1186/s13613-016-0173-1 doi (DE-627)SPR031929265 (SPR)s13613-016-0173-1-e DE-627 ger DE-627 rakwb eng 610 ASE Engele, Leo J. verfasserin aut Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection. Nosocomial infection (dpeaa)DE-He213 Critically ill (dpeaa)DE-He213 Red blood cells (dpeaa)DE-He213 Fresh-frozen plasma (dpeaa)DE-He213 Platelets (dpeaa)DE-He213 Transfusion (dpeaa)DE-He213 Straat, Marleen verfasserin aut van Rooijen, Ingeborg H. M. verfasserin aut de Vooght, Karen M. K. verfasserin aut Cremer, Olaf L. verfasserin aut Schultz, Marcus J. verfasserin aut Bos, Lieuwe D. J. verfasserin aut Juffermans, Nicole P. verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 6(2016), 1 vom: 19. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:6 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s13613-016-0173-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 1 19 07
allfieldsSound	10.1186/s13613-016-0173-1 doi (DE-627)SPR031929265 (SPR)s13613-016-0173-1-e DE-627 ger DE-627 rakwb eng 610 ASE Engele, Leo J. verfasserin aut Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection. Nosocomial infection (dpeaa)DE-He213 Critically ill (dpeaa)DE-He213 Red blood cells (dpeaa)DE-He213 Fresh-frozen plasma (dpeaa)DE-He213 Platelets (dpeaa)DE-He213 Transfusion (dpeaa)DE-He213 Straat, Marleen verfasserin aut van Rooijen, Ingeborg H. M. verfasserin aut de Vooght, Karen M. K. verfasserin aut Cremer, Olaf L. verfasserin aut Schultz, Marcus J. verfasserin aut Bos, Lieuwe D. J. verfasserin aut Juffermans, Nicole P. verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 6(2016), 1 vom: 19. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:6 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s13613-016-0173-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2016 1 19 07
language	English
source	Enthalten in Annals of intensive care 6(2016), 1 vom: 19. Juli volume:6 year:2016 number:1 day:19 month:07
sourceStr	Enthalten in Annals of intensive care 6(2016), 1 vom: 19. Juli volume:6 year:2016 number:1 day:19 month:07
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Nosocomial infection Critically ill Red blood cells Fresh-frozen plasma Platelets Transfusion
dewey-raw	610
isfreeaccess_bool	true
container_title	Annals of intensive care
authorswithroles_txt_mv	Engele, Leo J. @@aut@@ Straat, Marleen @@aut@@ van Rooijen, Ingeborg H. M. @@aut@@ de Vooght, Karen M. K. @@aut@@ Cremer, Olaf L. @@aut@@ Schultz, Marcus J. @@aut@@ Bos, Lieuwe D. J. @@aut@@ Juffermans, Nicole P. @@aut@@
publishDateDaySort_date	2016-07-19T00:00:00Z
hierarchy_top_id	664260918
dewey-sort	3610
id	SPR031929265
language_de	englisch
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However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). 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author	Engele, Leo J.
spellingShingle	Engele, Leo J. ddc 610 misc Nosocomial infection misc Critically ill misc Red blood cells misc Fresh-frozen plasma misc Platelets misc Transfusion Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill
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topic_title	610 ASE Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill Nosocomial infection (dpeaa)DE-He213 Critically ill (dpeaa)DE-He213 Red blood cells (dpeaa)DE-He213 Fresh-frozen plasma (dpeaa)DE-He213 Platelets (dpeaa)DE-He213 Transfusion (dpeaa)DE-He213
topic	ddc 610 misc Nosocomial infection misc Critically ill misc Red blood cells misc Fresh-frozen plasma misc Platelets misc Transfusion
topic_unstemmed	ddc 610 misc Nosocomial infection misc Critically ill misc Red blood cells misc Fresh-frozen plasma misc Platelets misc Transfusion
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title	Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill
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title_full	Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill
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author_browse	Engele, Leo J. Straat, Marleen van Rooijen, Ingeborg H. M. de Vooght, Karen M. K. Cremer, Olaf L. Schultz, Marcus J. Bos, Lieuwe D. J. Juffermans, Nicole P.
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title_sort	transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill
title_auth	Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill
abstract	Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection.
abstractGer	Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection.
abstract_unstemmed	Background Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is not known whether specific blood products have differential risks. Methods In this prospective multicentre cohort study, the risk of bacterial infections associated with transfusion products in critically ill (ICU) patients was determined in an integrated statistical model, using Cox proportional hazard analysis to account for attrition bias. In all acutely admitted patients with a length of stay of >48 h between 1 January 2011 and 31 December 2012, the occurrence of nosocomial infections in the ICU was prospectively monitored using CDC criteria. Results Of 3502 screened patients, 476 (13.6 %) developed a nosocomial infection. These patients had higher APACHE IV scores, had longer ICU length of stay and were more frequently transfused compared to patients without an infection. Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). Conclusions In critically ill patients, transfusion of platelets, but not of RBCs and plasma, is an independent risk factor for acquiring a nosocomial infection.
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title_short	Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill
url	https://dx.doi.org/10.1186/s13613-016-0173-1
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author2	Straat, Marleen van Rooijen, Ingeborg H. M. de Vooght, Karen M. K. Cremer, Olaf L. Schultz, Marcus J. Bos, Lieuwe D. J. Juffermans, Nicole P.
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up_date	2024-07-04T01:52:32.562Z
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Logistic regression showed that RBC transfusion was a risk factor for infection [odds ratio (OR) 1.98, 95 % confidence interval (CI) 1.54–2.55, p < 0.001], as well the number of RBC units transfused (OR 1.04, 95 % CI 1.03–1.06, p < 0.001). However, these associations disappeared in the Cox proportional hazard analysis. In contrast, we found an association between plasma transfusion and infection [hazard ratio (HR) 1.36, 95 % CI 1.10–1.69, p = 0.004] and between platelet transfusion and infection (HR 1.46, 95 % CI 1.18–1.81, p < 0.001). However, only platelet transfusion was associated with infection independently from other transfusion products (HR 1.40, 95 % CI 1.03–1.90, p = 0.03). 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