Healthcare-Associated Infections in a Cardiac Surgery Service in Brazil

Abstract

Objectives The study aimed to determine the incidence of healthcare-associated infections (HAI) and their sites in a cardiac surgery service, as well as to determine if gender and age were risk factors for infection and to quantify mortality and increase in the hospital length of stay (LOS) due to HAI. Methods Medical records of patients who underwent cardiac surgery from January 2012 to January 2018 were retrospectively analyzed. Data on age, gender, mortality, occurrence of HAI during hospitalization, and LOS were collected. Continuous variables were analyzed using Student's t -test, while categorical variables were compared using Fisher's exact test or chi-square test. Results Among the 195 patients available, the HAI rate in our service was 22.6%, with female gender being a risk factor for infections (odds ratio [OR]=2.23; P =0.015). Age was also a significant risk factor for infections, with a difference in the mean age between the group with and without infection ( P =0.02). The occurrence of an infectious process increased the LOS in 14 days ( P <0.001) and resulted in higher mortality rates ( P =0.112). A patient who has HAI was approximately 19 times more likely to remain hospitalized for more than nine days ( P <0.001). Conclusion Age and gender were risk factors for the development of HAI and the occurrence of an infectious process during hospitalization significantly increases the LOS. These findings may guide future actions aimed at reducing the impact of HAI on the health system.

Performance of a novel risk model for deep sternal wound infection after coronary artery bypass grafting

“…In this study, the incidence of DSWI was 2.47% (30-day follow-up) and the prognostic model was restricted to patients undergoing primary isolated CABG. Of 55 variables candidates in REPINF, 7 emerged from the LASSO logistic regression: female gender 14 – 16 , BMI 14 , 17 – 19 , diabetes 1 , 17 – 19 , hemoglobin 18 , emergency surgery status 18 , 20 , 21 , surgery duration 18 , 21 and bilateral internal thoracic artery (BITA) used 22 – 24 . All variables included in the LASSO regression in the new model have already been described as risk factors for DSWI.…”

Surgical site infection in adult patients after heart procedures: an integrative review

“…Dos 10 artigos que citaram taxa de mortalidade associada à infecção de sítio cirúrgico, a variação foi entre 2,4% (29) a 38,9% (33) . Os estudos foram conduzidos em vários países incluindo Alemanha (20)(21) , Grécia (34) , Holanda (35) , Irã (30) , Itália (19)(20) , Qatar (23) , Singapura (22) , Estados Unidos da América (24)(25)29,31) , multinacionais (17) e os demais no Brasil (5,8,13,(15)(16)18,(32)(33) .…”

“…(26) . Além disso, nove dos estudos selecionados também mencionam a correlação entre a incidência de infecção de sítio cirúrgico e outras Infecções relacionadas à assistência à saúde, tais como: Infecção do trato urinário (8,21,(24)(25)(26)(27)34) ; Infecção de corrente sanguínea (24,(26)(27)(28)(29) ; e pneumonia (8,(24)(25)(26)(27)(28)34) .…”

“…Em território brasileiro, entende-se que as infecções de sítio cirúrgico ocupam o terceiro lugar em infecções relacionadas à assistência à saúde, representando cerca de 14 a 16% dos quadros apresentados pelos pacientes internados (5)(6) . A ISC é associada a um aumento de mortalidade, além de prolongar o período de internação (7)(8) . Possui uma taxa de mortalidade média de 3%, destacando o fato de 75% das mortes de pacientes com infecção de sítio cirúrgico serem diretamente ligadas ao processo infeccioso como causa primária do óbito (9)(10) .…”

Performance of a Novel Risk Model for Deep Sternal Wound Infection after Coronary Artery Bypass Grafting

“…In this study, the incidence of DSWI was 2.47% (30-day follow-up) and the prognostic model was restricted to patients undergoing primary isolated CABG. Of 55 variables candidates in REPINF, 7 emerged from the LASSO logistic regression: female gender [14][15][16], BMI [14,[17][18][19], diabetes [1,17,18,19], hemoglobin [18], emergency surgery status [18,20,21], surgery duration [18,21] and bilateral internal thoracic artery (BITA) used [22,23,24]. All variables included in the LASSO regression in the new model have already been described as risk factors for DSWI.…”