Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type.

Published

Journal Article

BACKGROUND: Major postoperative infections (MPIs) are poorly understood complications of cardiac surgery. We examined the epidemiology, microbiology, and outcome of MPIs occurring after cardiac surgery. METHODS: The study cohort was drawn from the Society of Thoracic Surgeon National Cardiac Database and comprised adults who underwent cardiac surgery at 5 tertiary hospitals between 2000 and 2004. We studied the incidence, microbiology, and risk factors of MPI (bloodstream or chest wound infections within 30 days after surgery), as well as 30-day mortality. We used multivariate regression analyses to evaluate the risk of MPI and mortality. RESULTS: MPI was identified in 341 of 10,522 patients (3.2%). Staphylococci were found in 52.5% of these patients, gram-negative bacilli (GNB) in 24.3%, and other pathogens in 23.2%. High body mass index, previous coronary bypass surgery, emergency surgery, renal impairment, immunosuppression, cardiac failure, and peripheral/cerebrovascular disease were associated with the development of MPI. Median postoperative duration of hospitalization (15 days vs 6 days) and mortality (8.5% vs 2.2%) were higher in patients with MPIs. Compared with uninfected individuals, odds of mortality were higher in patients with S aureus MPIs (adjusted odds ratio, 3.7) and GNB MPIs (adjusted odds ratio, 3.0). CONCLUSIONS: Staphylococci accounted for the majority of MPIs after cardiac surgery. Mortality was higher in patients with Staphylococcus aureus- and GNB-related MPIs than in patients with MPIs caused by other pathogens and uninfected patients. Preventive strategies should target likely pathogens and high-risk patients undergoing cardiac surgery.

Full Text

Duke Authors

Cited Authors

  • Chen, LF; Arduino, JM; Sheng, S; Muhlbaier, LH; Kanafani, ZA; Harris, AD; Fraser, TG; Allen, K; Corey, GR; Fowler, VG

Published Date

  • December 2012

Published In

Volume / Issue

  • 40 / 10

Start / End Page

  • 963 - 968

PubMed ID

  • 22609237

Pubmed Central ID

  • 22609237

Electronic International Standard Serial Number (EISSN)

  • 1527-3296

Digital Object Identifier (DOI)

  • 10.1016/j.ajic.2012.01.012

Language

  • eng

Conference Location

  • United States