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‘Old blood’ linked to doubled rate of infections

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CHEST 2008

PHILADELPHIA — The results of a retrospective study conducted at Cooper University Hospital in Camden, N.J., showed that patients who received blood more than 29 days old had twice the rate of infection compared with patients who received newer blood.

Raquel Nahra, MD, formerly a staff physician at Cooper, presented the findings at CHEST 2008, the 74th annual international scientific assembly of the American College of Chest Physicians, held in Philadelphia.

Upon reviewing the cases of 422 patients who received transfusions between July 2003 and September 2006, the researchers found that those who received blood aged older than 29 days were at increased risk for nosocomial infections (OR=2.9; P=.01).

Patients who developed infections, in general, received transfusions of older blood (28.5 days vs. 32 days).

“The older the blood, the higher the rate of infection,” Nahra told HemOnc Today. “The average age of the blood pool was 26 days. The blood older than 29 days was associated with 2.9-fold increased risk of developing a hospital-acquired infection.”

Nahra noted blood age did not appear to impact mortality. She added that patients who received five or more units of blood were also at increased risk for at least one infection.

She also said that the researchers could not control how blood was administered and said that more studies are needed before changing clinical practice. – by Jason Harris

For more information:

• Nahra R. #7066. Presented at: CHEST 2008; Oct. 25-30, 2008; Philadelphia.

There are several next steps. One is: do another study and really confirm this in a prospective, controlled fashion — Dr. Nahra pointed out accurately that none of the practice was controlled. The other important thing is that those people who got more blood were more likely to get infections. That’s to be expected; if you get more units of blood you’re sicker, you’re more likely to have invasive procedures, you’re more likely to stay longer in the intensive care unit. More studies need to be done and, in addition, there needs to be some sort of strong and concerted effort to bring rational controls on how we distribute blood.

– Mark J. Rosen, MD

Chief of Pulmonary, Critical Care and Sleep Medicine
North Shore Health System