Estudio prospectivo sobre factores de riesgo de infección nosocomial después de cirugía cardíaca pediátrica / Risk factors of nosocomial infections after pediatric cardiac surgery. Prospective study
Salud(i)ciencia (Impresa)
; 16(4): 415-419, sept. 2008. tab
Article
em Es
| LILACS
| ID: biblio-836564
Biblioteca responsável:
AR144.1
RESUMEN
Se realizó un estudio prospectivo, observacional, analítico con el objetivo de evaluar la influencia de determinados factores sobre el desarrollo de infecciones nosocomiales en pacientes sometidos a cirugía cardíaca en el Cardiocentro Pediátrico William Soler durante 2006. Fueron estudiadas variables preoperatorias, intraoperatorias y posoperatorias en los grupos de pacientes con infección nosocomial y sin infección nosocomial. De 228 pacientes, 26 (11.4%) presentaron 43 episodios de IN (tasa de episodios de IN = 18.9). Los principales factores de riesgo fueron nutrición parenteral, [OR 27.8 (IC 95% 9.4-81.7)], categoría 4 de RACHS-1 [RR 17 (IC 95% 3.17-91.27) reintubación traqueal [OR 10.3(IC 95% 3.3-32.4)], antibioticoterapia preoperatoria [OR9.0 (IC 95% 2.1-38.5), volumen de hemoderivados> de 50 ml/kg [RR 7.9 (IC 95%; 3.3-18.9); p = 0.000],sonda vesical = 7 días [RR 6.7 (IC 3.4-13.4); p = 0.002],catéter venoso central = 7 días [RR 5.7 (IC 95%;2.7-12.2); p = 0.004] y tiempo de pinzamiento aórtico> de 100 minutos [RR 5.0 (IC 95%; 2.2-11.5); p = 0.018].La nutrición parenteral, un elevado puntaje de complejidad quirúrgica (RACHS-1), reintubación traqueal, uso de antibioticoterapia preoperatoria y la transfusión masivade hemoderivados fueron las variables asociadas a los más elevados riesgos de infección nosocomial.
ABSTRACT
Objective:
to assess de influence of risk factors on the development of nosocomial infections in patients subjected to cardiac surgery.Design:
A prospective, 1 year study.Setting:
A pediatric cardiac surgery service, national referral center.Subjects:
All patients whounderwent cardiac surgery from January 1, 2006, to December 31, 2006 were enrolled, except patients whodied the first 48 hours after surgery or those with evidenceof infection at o not survived.Interventions:
None. Measurement and mainresults:
Preoperative, intraoperativeand postoperative variables were compared between patients who developed nosocomial infections and those patients who did not. Out of 228 patients, 26(11.4%) developed at least one episodes of nosocomial infections. The main risk factors were parenteral nutrition[RR 27.8 (95% CI 9.4-81.7)], category 4 of RACHS-1score [RR 17 (95% CI 3.17-91.27), tracheal reintubation[RR 10.3 (95% CI 3.3-32.4)], preoperative antibiotic use[RR 9.0 (95% CI 2.1-38.5), blood products transfusion> de 50 ml/kg [RR 7.9 (95% CI 3.3-18.9); p = 0.000], urinary catheter = 7 days [RR 6.7 (95% CI 3.4-13.4);p = 0.002], central venous catheter = 7 days [RR 5.7(95% CI 2.7-12.2); p = 0.004], and aortic clamp time> 100 minutes [RR 5.0 (95% CI 2.2-11.5); p = 0.018].Conclusions:
Parenteral nutrition, high score of RACHS-1, tracheal reintubation, preoperative antibiotic therapy andmassive transfusion were the variables associated with the higher risks of nosocomial infections.Palavras-chave
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Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Cirurgia Torácica
/
Infecção Hospitalar
/
Fatores de Risco
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
Es
Revista:
Salud(i)ciencia (Impresa)
Assunto da revista:
CIENCIA
/
MEDICINA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Cuba
País de publicação:
Argentina