Transfusion of packed red blood cells stored >14 days was associated with a higher risk of infection after hip revision arthroplasty.

Purpose: Transfusion of packed red blood cells (RBCs) stored for >14 days has been associated with a higher risk of infection but there is no data about the impact in revision hip arthroplasty.
Methods: We retrospectively reviewed 280 patients who underwent revision hip arthroplasty from January 2002 to May 2012. Relevant risk factors and prosthetic joint infection (PJI) rate after 100 days after surgery were collected.
Results: 10 patients out of 280 (3.6%) had a PJI within the first 100 days after revision surgery. The PJI rate in patients receiving an early transfusion (during surgery or within the first 12 hours) of packed RBCs with a length of storage >14 days was higher (8.0%) than the rate in nontransfused patients (1.8%) or those receiving an early transfusion of packed RBCs with a length of storage ≤14 days (2.6%, p = 0.05). A Cox regression model identified transfusion of packed RBCs stored >14 days as the only independent predictor of PJI (hazard ratio [HR] = 4.54; 95% confidence interval [CI], 1.13-18.15; p = 0.032).
Conclusions: The only independent predictor of PJI was early transfusion of packed RBCs stored >14 days. Therefore, a potential way for reducing the PJI rate could be the selection of young packed RBCs.