Einstein (São Paulo) (Jun 2005)
Risk factors for surgical-site infection after cardiac surgery
Abstract
Objective: Surgical site infection is a serious complication inpatients undergoing heart surgery because in addition to highmorbitity rates, length of hospital stay and hospital costs areincreased. This study aims to identify pre-, peri- and postoperativerisk factors related to surgical-site infection after cardiac surgery.Methods: The study comprised 1053 patients undergoing cardiacsurgery, with sternotomy, performed consecutively, between June1 and October 31, 1999, by three cardiac surgery teams. Therecommendations of the Centers for Disease Control and Preventionwere followed for surgical site infection diagnosis and classification.Sixteen pre-, peri- and postoperative risk factors and the presenceof surgical site infection in the chest area were evaluated byunivariate analysis followed by logistic regression analysis. Apost-surgery surgical site surveillance was performed by meansof a questionnaire and either personal or telephone contact withthe patients. Results: The incidence of surgical site infection was4.18% (44 cases); in that, 2.85% (30) were superficial, 0.95% (10)deep and 0.38% (4) mediastinitis. Diagnosis of 56.80% was madefollowing hospital discharge. Staphylococcus was the mostfrequent microorganism in the surgical site infection (57%). Amongthe risk factors analyzed, the surgeries performed by the A(p=0.020) and B (p=0.020) medical teams remained independentrisk factors in the development of surgical site infections.Conclusions: In the population studied, the incidence was small,particularly of deep surgical site infection and mediastinitis; postdischargesurveillance made a major impact on diagnosis andincidence; and the major risk factors in the development of surgicalsite infection were the surgeries performed by the A and B medicalteams, most likely because of their intraoperative surgicaltechniques.
