Allogeneic blood transfusion is a significant risk factor for surgical site infection following total hip and knee arthroplasty: A meta-analysis

Abstract Background Blood loss occurs significantly more frequently during total hip and knee replacement arthroplasty than among any other type of orthopedic operation, which can sometimes lead to requiring a blood transfusion. Although allogeneic blood transfusion has been identified as a risk factor for post-operative surgical site infection following arthroplasty, results are inconclusive. The purpose of this study was to conduct a systematic meta-analysis to investigate whether having an allogeneic blood transfusion significantly increases the risk for surgical site infection, particularly after total hip and knee arthroplasty. Methods We performed a systematic review and meta-analysis using random-effect models. Using an electronic database search, we selected six studies that included data on 21,770 patients and among these studies compared the post-operative infection rate between an allogeneic blood-transfusion exposure group and a non-exposure group. We calculated the pooled odds ratios (OR) and 95% confidence intervals (CI) for the groups. Results The prevalences of surgical site infections in our pooled analyses were 2.88% and 1.74% for the transfusion and non-transfusion groups, respectively. The allogeneic blood transfusion group had a significantly higher frequency of surgical site infections based on pooled analysis using a random-effect model (pooled OR = 1.71, 95% CI: 1.23 – 2.40, P = 0.002). Conclusion Allogeneic blood transfusion is a significant risk factor for increasing the surgical site infection rate after total hip and knee arthroplasty.