The Correlation Between Blood Transfusion And Postoperative Infection In Spinal Surgery:A Meta-analysis

Background:Blood transfusions are associated with many adverse postoperative complications in spine surgery,but it remains unclear whether blood transfusion during the surgery and postoperative infection are related.In the existing researches on the relationship between blood transfusion and infection,the differences of transfusion strategies and infection types are diversified,and the relevant conclusions are also different,or even completely opposite.In addition,postoperative spinal infection can lead to more serious complications,including failure of fixation and fusion,spinal canal infection and even intracranial infection.Therefore,it is significantly important to study the correlation between blood transfusion and postoperative infection in spinal surgery.Objective:A Meta-analysis were performed to systematically evaluate the correlation between blood transfusion and postoperative infection in spinal surgery,provide evidence-based medical evidence for spinal surgery and formulate a more appropriate blood transfusion policy.Methods:First of all,Pubmed、Web of Science、Embase、Cochrane databases were searched by computer to search all the literatures about whether blood transfusion in spine surgery can lead to infection from the establishment of the database to September 2020.The combination of subject words and free words is supplemented by manual retrieval of relevant citations,excluding the unpublished literature.According to the set inclusion and exclusion criteria,the literature which was finally included in the study was obtained.After incorporating the literature quality evaluation,the data were extracted and Meta-analysis was carried out by Revman5.3software.Result:A total of 11 articles were included,involving 36141 surgical patients,including 10893 blood transfusion patients and 25248 non transfusion patients.The results of Meta-analysis showed that blood transfusion and surgical site infection(OR=2.24,95%CI为1.43-3.53,p=0.0005,I~2=34%),urinary tract infection(OR=3.26,95%CI为2.00-5.33,p<0.00001,I~2=61%),sepsis(OR=2.08,95%CI为1.23-3.54,p=0.007,I~2=0%)after spinal surgery.There was no correlation between blood transfusion and postoperative pneumonia(OR=1.99,95%CI为0.86-4.59,p=0.11,I~2=85%)after spinal surgery.Conclusion:According to the available research data,there is a correlation between blood transfusion and postoperative urethral infection,septicemia and surgical site infection.There is not enough evidence to prove the correlation between blood transfusion and postoperative pneumonia.