Risk factors for coronary artery bypass graft chest surgical site infections in New York State, 2008

Haley, Valerie B.; Antwerpen, Carole Van; Tsivitis, Marie; Doughty, Diana; Gase, Kathleen A.; Hazamy, Peggy Ann; Tserenpuntsag, Boldtsetseg; Racz, Michael; Yücel, Muammer; McNutt, Louise‐Anne; Stricof, Rachel L.

doi:10.1016/j.ajic.2011.06.015

Cited by 23 publications

(19 citation statements)

References 16 publications

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“…[29,30] It is likely that the benefits of glucose control extend to cardiac surgical patients, as most of the large-scale glucose control studies included cardiothoracic surgery patients and as poor glucose control is associated with a higher risk of SSI. [5,31,32] In this study, CPB time, aortic cross-clamp time, operation time, length of stay in the ICU, blood transfusion, blood glucose regulation, and type of surgery did not show a significant correlation with the SSI development. However, the use of IABP was found to be significantly associated with the SSI development.…”

Section: Discussioncontrasting

confidence: 50%

Rehospitalization with surgical site infections after cardiac surgery

İbrahimoğlu¹

2019

Cardiovasc Surg Int

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This study aims to investigate rehospitalization rates in patients with surgical site infections (SSIs) after cardiac surgery. Patients and methods: This cross-sectional study included a total of 153 patients (121 males, 32 females; mean age 58.7±10.9 years; range, 18 to 80 years) who underwent open heart surgery in our cardiovascular surgery clinic and readmitted with SSI within 30 days after surgery between September 2014 and December 2014. Risk factors which were related to the patient, surgery, and hospital stay were evaluated. Results: Of the patients, 73.8% had coronary artery bypass grafting (CABG). A total of 22 patients (14.4%) were readmitted to hospital after discharge with SSI. Half of them had saphenous infections (superficial infection n=8, deep infection n=3), while the other half had sternal infections (superficial infection n=7, deep infection n=4). Nine of these patients were rehospitalized. The mean length of hospital stay was 14.2±3.8 (range, 10 to 20) days. The risk factors for SSI development included patient, surgery, and hospitalization and hospital setting. Conclusion: Our study results show that several risk factors may play a role in the development of SSIs and rehospitalization. Therefore, it is recommended that nurses consider that SSI is certainly a major complication after cardiac surgery and the risks should be minimized during procedure and after discharge.

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Section: Discussioncontrasting

confidence: 50%

Rehospitalization with surgical site infections after cardiac surgery

İbrahimoğlu¹

2019

Cardiovasc Surg Int

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“…The classic risk factors for SSIs after cardiothoracic surgeries are diabetes mellitus, prior cardiothoracic surgery, obesity and old age . Diabetes and prior cardiothoracic surgery were independent risk factors for SSIs in our patients , but obesity and age were not.…”

Section: Discussionmentioning

confidence: 50%

“…To our knowledge, however, no study has investigated surgical site infections (SSIs) among LTx recipients. The lack of data is surprising, especially since the risk factors of SSIs and their associated poor outcomes are well‐recognized in nontransplant cardiothoracic surgeries . The objective of this study was to investigate the epidemiology, clinical manifestations, microbiology, risk factors and outcomes of SSIs following LTx.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Outcomes of Deep Surgical Site Infections Following Lung Transplantation

Shields

Clancy

Minces

et al. 2013

American Journal of Transplantation

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We conducted a retrospective study of deep surgical site infections (SSIs) among consecutive patients who underwent lung transplantation (LTx) at a single center from 2006 through 2010. Thirty-one patients (5%) developed SSIs at median 25 days after LTx. Empyema was most common (42%), followed by surgical wound infections (29%), mediastinitis (16%), sternal osteomyelitis (6%), and pericarditis (6%). Pathogens included Gram-positive bacteria (41%), Gram-negative bacteria (41%), fungi (10%) and Mycobacterium abscessus, Mycoplasma hominis and Lactobacillus sp. (one each). Twenty-three percent of SSIs were due to pathogens colonizing recipients' native lungs at time of LTx, suggesting surgical seeding as a source. Patient-related independent risk factors for SSIs were diabetes and prior cardiothoracic surgery; procedure-related independent risk factors were LTx from a female donor, prolonged ischemic time and number of perioperative red blood cell transfusions. Mediastinitis and sternal infections were not observed among patients undergoing minimally invasive LTx. SSIs were associated with 35% mortality at 1 year post-LTx. Lengths of stay and mortality inhospital and at 6 months and 1 year were significantly greater for patients with SSIs other than empyema. In conclusion, deep SSIs were uncommon, but important complications in LTx recipients because of their diverse microbiology and association with increased mortality.

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“…The risk is the highest during the postoperative period, when there is exposure of the tissue and entry of microorganisms into the surgical site is possible. There are several factors that can increase risk of infection, which may be endogenous, such as advanced age, obesity, and diabetes, or exogenous, such as breaking the aseptic barrier, inadequate hand hygiene, wound classification, duration of the procedures, and the surgical technique (29)(30)(31). Open heart surgical procedures often are invasive, involving the prolonged use of supporting devices and indwelling intravenous lines, and the introduction of foreign materials and tissues, such as prosthetic valves, into the body.…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Model for Vancomycin Used in Open Heart Surgery: Model-Based Evaluation of Standard Dosing Regimens

Alqahtani

Alsultan

Alqattan

et al. 2018

Antimicrob Agents Chemother

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The purpose of this study was to investigate the population pharmacokinetics of vancomycin in patients undergoing open heart surgery. In this observational pharmacokinetic study, multiple blood samples were drawn over a 48-h period of intravenous vancomycin in patients who were undergoing open heart surgery. Blood samples were analyzed using an Architect i4000SR immunoassay analyzer. Population pharmacokinetic models were developed using Monolix 4.4 software. Pharmacokinetic-pharmacodynamic (PK-PD) simulations were performed to explore the ability of different dosage regimens to achieve the pharmacodynamic targets. A total of 168 blood samples were analyzed from 28 patients. The pharmacokinetics of vancomycin are best described by a two-compartment model with between-subject variability in clearance (CL), the volume of distribution of the central compartment (), and volume of distribution of the peripheral compartment (). The CL and the of vancomycin were related to creatinine CL (CL), body weight, and albumin concentration. Dosing simulations showed that standard dosing regimens of 1 and 1.5 g failed to achieve the PK-PD target of AUC/MIC > 400 for an MIC of 1 mg/liter, while high weight-based dosing regimens were able to achieve the PK-PD target. In summary, the administration of standard doses of 1 and 1.5 g of vancomycin two times daily provided inadequate antibiotic prophylaxis in patients undergoing open heart surgery. The same findings were obtained when 15- and 20-mg/kg doses of vancomycin were administered. Achieving the PK-PD target required higher doses (25 and 30 mg/kg) of vancomycin.

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Risk factors for coronary artery bypass graft chest surgical site infections in New York State, 2008

Cited by 23 publications

References 16 publications

Rehospitalization with surgical site infections after cardiac surgery

Rehospitalization with surgical site infections after cardiac surgery

Epidemiology and Outcomes of Deep Surgical Site Infections Following Lung Transplantation

Population Pharmacokinetic Model for Vancomycin Used in Open Heart Surgery: Model-Based Evaluation of Standard Dosing Regimens

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