Impact of nosocomial infections on patient mortality following cardiac surgery

Varga-Martínez, Olga de la; Gómez-Sánchez, Esther; Muñoz, Mauricio Pastor; Lorenzo, Mario; Gómez-Pesquera, Estefanía; Poves-Álvarez, Rodrigo; Tamayo, Eduardo; Heredia-Rodríguez, María

doi:10.1016/j.jclinane.2020.110104

Cited by 18 publications

(28 citation statements)

References 25 publications

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“…2,3 Hospital-acquired infection (HAI), a relatively common complication after cardiac operations, is an important cause of prolonged hospital stays and higher concomitant costs. [4][5][6] Cardiac patients are promisingly perceived as a risky subset to encounter postoperative HAI, as they vary greatly from those with noncardiac procedures due in part to the frequent utilization of invasive monitoring procedures, including venous and arterial catheters, prolonged mechanical ventilation time and, specifically, exposure to cardiopulmonary bypass (CPB). 7,8 We preferred elderly patients as our purposed study candidates, which is rooted in population aging, as advanced age is gradually predominating worldwide.…”

Section: Introductionmentioning

confidence: 99%

Establishment and Validation of a Nomogram to Predict Hospital-Acquired Infection in Elderly Patients After Cardiac Surgery

Gao¹,

Wang²,

Wang³

et al. 2022

CIA

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Background: Hospital-acquired infection (HAI) after cardiac surgery is a common clinical concern associated with adverse prognosis and mortality. The objective of this study is to determine the prevalence of HAI and its associated risk factors in elderly patients following cardiac surgery and to build a nomogram as a predictive model. Methods: We developed and internally validated a predictive model from a retrospective cohort of 6405 patients aged ≥70 years, who were admitted to our hospital and underwent cardiac surgery. The primary outcome was HAI. Multivariable logistic regression analysis was used to identify independent factors significantly associated with HAI. The performance of the established nomogram was assessed by calibration, discrimination, and clinical utility. Internal validation was achieved by bootstrap sampling with 1000 repetitions to reduce the overfit bias. Results: Independent factors derived from the multivariable analysis to predict HAI were smoking, myocardial infarction, cardiopulmonary bypass use, intraoperative erythrocytes transfusion, extended preoperative hospitalization days and prolonged duration of mechanical ventilation postoperatively. The derivation model showed good discrimination, with a C-index of 0.706 [95% confidence interval 0.671-0.740], and good calibration [Hosmer-Lemeshow test P = 0.139]. Internal validation also maintained optimal discrimination and calibration. The decision curve analysis revealed that the nomogram was clinically useful. Conclusions: We developed a predictive nomogram for postoperative HAIs based on routinely available data. This predictive tool may enable clinicians to achieve better perioperative management for elderly patients undergoing cardiac surgery but still requires further external validation.

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Section: Introductionmentioning

confidence: 99%

Establishment and Validation of a Nomogram to Predict Hospital-Acquired Infection in Elderly Patients After Cardiac Surgery

Gao¹,

Wang²,

Wang³

et al. 2022

CIA

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show abstract

“…Unsurprisingly, the length of CPB was independently related to the development of POP following ECS in our analysis, which was consistent with most of the existing reports ( 1 ). Olga et al reported that the duration of CPB was an independent risk factor for the development of POP following cardiac surgery, with an increased risk of 1% per min ( 20 ). A meta-analysis conducted by He et al indicated that prolonged CPB may significantly increase the probability of POP following cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Nomogram Models for Postoperative Pneumonia in Adult Patients Undergoing Elective Cardiac Surgery

Wang

Chen

et al. 2021

Front. Cardiovasc. Med.

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Background: Postoperative pneumonia (POP) is a frequent complication following cardiac surgery, related to increased morbidity, mortality and healthcare costs. The objectives of this study were to investigate the risk factors associated with POP in adults undergoing elective cardiac surgery and to develop and validate nomogram models.Methods: We conducted a multicenter retrospective study in four cardiac centers in China. Adults operated with elective open-heart surgery from 2016 to 2020 were included. Patients were randomly allocated to training and validation sets by 7:3 ratio. Demographics, comorbidities, laboratory data, surgical factors, and postoperative outcomes were collected and analyzed. Risk factors for POP were identified by univariate and multivariate analysis. Nomograms were constructed based on the multivariate logistic regression models and were evaluated with calibration, discrimination and decision curve analysis.Results: A total of 13,380 patients meeting the criteria were included and POP developed in 882 patients (6.6%). The mortality was 2.0%, but it increased significantly in patients with POP (25.1 vs. 0.4%, P < 0.001). Using preoperative and intraoperative variables, we constructed a full nomogram model based on ten independent risk factors and a preoperative nomogram model based on eight preoperative factors. Both nomograms demonstrated good calibration, discrimination, and were well validated. The decision curves indicated significant clinical usefulness. Finally, four risk intervals were defined for better clinical application.Conclusions: We developed and validated two nomogram models for POP following elective cardiac surgery using preoperative and intraoperative factors, which may be helpful for individualized risk evaluation and prevention decisions.

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“…Unsurprisingly, the length of CPB was independently related to the development of POP following ECS in our analysis, which was consistent with most of the existing reports (1). Olga et al reported that the duration of CPB was an independent risk factor for the development of POP following cardiac surgery, with an increased risk of 1% per min (20). A meta-analysis conducted by He et al indicated that prolonged CPB may significantly increase the probability of POP following cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation Of Nomogram Models For Postoperative Pneumonia In Adult Patients Undergoing Elective Cardiac Surgery

Wang

Chen

et al. 2021

SSRN Journal

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Impact of nosocomial infections on patient mortality following cardiac surgery

Cited by 18 publications

References 25 publications

Establishment and Validation of a Nomogram to Predict Hospital-Acquired Infection in Elderly Patients After Cardiac Surgery

Establishment and Validation of a Nomogram to Predict Hospital-Acquired Infection in Elderly Patients After Cardiac Surgery

Development and Validation of Nomogram Models for Postoperative Pneumonia in Adult Patients Undergoing Elective Cardiac Surgery

Development and Validation Of Nomogram Models For Postoperative Pneumonia In Adult Patients Undergoing Elective Cardiac Surgery

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