Nosocomial infections in patients having cardiovascular operations: A multivariate analysis of risk factors

Abstract

A total of 970 adult patients undergoing cardiovascular operations during a 1-year period were eligible for a case-control study on the risk factors for nosocomial infection. Cases were defined as patients in whom a postoperative infection developed. Every case was paired with one uninfected subject. Nosocomial infection occurred in 89 (9.2%) patients. A total of 120 episodes of infection were diagnosed (1.3 episodes per patient). The infection ratio was 12.4%. Surgical site infection was the most common (5.6%), followed by pneumonia (3.2%), urinary tract infection requiring the use of intravenous antibiotics (1.8%), deep surgical site (0.9%), and bacteremia (0.7%). Advanced age, urgent intervention, duration of surgical procedure, blood transfusion, and use of invasive procedures (urinary catheter, chest tubes, nasogastric tube passage) were significantly associated with infection in the bivariate analysis. Nosocomial infection resulted in a significant increase in the length of hospital stay. Cases showed an almost fivefold greater risk of death than controls (odds ratio, 4.73; 95% confidence interval, 1.11 to 6.83; p = 0.009). Age older than 65 years, female sex, and mode of surgical intervention were selected in the multivariate analysis for patients undergoing cardiac operations, whereas general anesthesia or assisted ventilation, central venous catheter, and blood transfusion were the variables selected for patients undergoing operation for vascular disorders. In summary, the recognition of risk factors for postoperative infection in patients undergoing cardiovascular surgical procedures may contribute to improve their prognosis and to more organized surveillance and control activities in the hospital environment.

Nosocomial Infections after Peripheral Arterial Bypass Surgery

“…Older age was found to be statistically significantly associated with a higher prevalence of nosocomial infections, a finding that has been previously demonstrated by other studies [13]. Of all variables studied, the preoperative use of corticosteroids was a risk factor for the development of a nosocomial infection.…”

Infecção hospitalar em pacientes cirúrgicos de Hospital Universitário

“…Considerando-se a topografia da infecção, o maior índice observado ocorreu na ferida operatória, coincidindo com os dados encontrados na literatura 4,7 , onde a infecção mais comum foi a da ferida operatória. Na presente casuística, esta apresentou-se com a incidência de 3,7% do total de operações realizadas, mas têm sido descritas incidências globais de 5,6%…”

Ventilator-Associated Pneumonia Is an Important Risk Factor for Mortality After Major Cardiac Surgery

“…The prevalence of VAP is estimated to be 7.8% to 21.6% [1][2][3] and is associated with prolonged hospitalization [4,5], increased health care costs [6], and a 15% to 45% attributable mortality [7].…”

“…At the same time, inhospital patients are also at risk for multiple postoperative events (eg, myocardial infarction [MI], congestive heart failure, acute renal failure, strokes) [1][2][3][4]16,18,19]. These comorbidities complicate the evaluation of the impact of VAP on mortality [17].…”