Healthcare-associated infections in the postoperative period after cardiac surgery
AbstractBackground: This study aimed to determine the incidence of healthcare-associated infections (HAIs) in patients undergoing cardiac surgery, analyzing data and clinical outcomes in patients with and without HAIs. Methods: This was a prospective cohort study involving 293 consecutive adult patients undergoing cardiac surgery between April 2011 and October 2012. Results: Of the 293 patients, 60 (24.9%) developed 73 HAIs: 24 surgical site infections, 24 pneumonias, 14 urinary tract infections (UTIs), and 11 bloodstream infections (BSIs). The incidence of ventilator-associated pneumonia was 14.6 cases/1,000 ventilator-days, whereas that of catheter-associated UTI was 7.15 cases/1,000 catheter-days and that of central line-associated BSI was 4.52 cases/1,000 central line-days. Of the 60 patients with HAIs, 20 (33%) died before postoperative day 90, compared with 18 (7.7%) of the 233 patients without HAIs (P < .001). Independent variables associated with infection were length of hospital stay (OR, 1.04; 95% CI, 1.01-1.06; P = .002), duration of urinary catheter use (OR, 1.19; 95% CI, 1.07-1.13; P = .001), and duration of central line use (OR, 1.07; 95% CI, 1.01-1.13; P = .032). Independent variables associated with mortality were Acute Physiology and Chronic Health Evaluation II score (OR, 1.27; 95% CI 1.14-1.42; P < .001), pneumonia (OR, 11.94; 95% CI, 3.83-37.17; P < .001), UTI (OR, 8.59; 95% CI, 1.91-38.7; P = .005), and BSI (OR, 6.16; 95% CI, 1.08-34.98; P = .040). Conclusion: Among the most important complications after cardiac surgery are HAIs. Patients who experience postoperative infections have increased length of hospital stay and mortality.
How to Cite
Authors retain copyright of their work, with first publication rights granted to IJIC. Read the full Copyright- and Licensing Statement.