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Blood transfusions lower the immune response – a known fact although not all doctors are aware of it. It is therefore nice to see that two new articles in JBJS that focus on the subject. Both focus on arthroplasties where the impact of an infection due to a lowered immune response can be catastrophic to the individual.
Infections after total hip are rare, about 1 % within the first two years, and are thereby difficult to study. In order to efficiently study the subject we often need to pooled studies, meta-analysis, or large registry based cohorts. A quick power calculation shows that if we want to show a 50 % reduction, then under optimum circumstances we need almost 10 000 patients (see R-code below).
Hill et al. noted already in 2003 in their meta-analys that bacterial infections were more frequent in those receiving allogenic blood transfusions (blood from another person). Odds of having an infection was more than 3 times higher among those that had received transfusions.
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