The role of patient's profile and allogeneic blood transfusion in development of post-cardiac surgery infections: a retrospective study.
Interact Cardiovasc Thorac Surg
; 19(2): 232-8, 2014 Aug.
Article
in En
| MEDLINE
| ID: mdl-24729199
ABSTRACT
OBJECTIVES:
We aimed to investigate the association of patient characteristics and allogeneic blood transfusion products in development of post-cardiac surgery nosocomial infections.METHODS:
This retrospective study was conducted in 7888 patients undergoing cardiac surgery with median sternotomy and cardiopulmonary bypass. Multivariable logistic regression analysis was used for independent effect of variables on infections.RESULTS:
A total of 970 (12.3%) patients developed one or several types of postoperative infections. Urinary (n = 351, 4.4%) and pulmonary tract infections (n = 478, 6.1%) occurred more frequently than sternal wound infections (superficial n = 102, 1.3%, deep n = 72, 0.9%) and donor site infections (n = 61, 0.8%). Interventions, including valve replacement (P = 0.002) and coronary artery bypass grafting combined with valve replacement (P = 0.012), were associated with increased risk of several types of postoperative infections. Patients' profiles changed substantially over the years; morbid obesity (P = 0.019), smoking (P = 0.001) and diabetes mellitus (P = 0.001) occur more frequently nowadays. Furthermore, surgical site infections showed to be related to morbid obesity (P < 0.001) and higher risk stratification (P = 0.031). Smoking (P < 0.001) and chronic obstructive pulmonary disease (P < 0.001) were related to pulmonary tract infections. In addition, diabetic patients developed more sepsis (P = 0.003) and advanced age was associated with development of urinary tract infections (P < 0.001). Even after correcting for other factors, blood transfusion was associated with all types of postoperative infection (P < 0.001). This effect remained present in both leucocyte-depleted and non-leucocyte-depleted transfusion.CONCLUSIONS:
Our data showed that post-cardiac surgery infections occur more frequently in patients with predetermined risk factors. The amount of blood transfusions was integrally related to every type of postoperative infection.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiratory Tract Infections
/
Surgical Wound Infection
/
Urinary Tract Infections
/
Cross Infection
/
Erythrocyte Transfusion
/
Cardiac Surgical Procedures
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Interact Cardiovasc Thorac Surg
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2014
Document type:
Article
Affiliation country:
Netherlands
Publication country:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM