Risk Factors for Healthcare-Associated Infections in Pediatric Cardiac Surgery

Abstract

Introduction: Congenital heart defects are one of the most common malformations. Almost 50 % of patients with congenital heart defects require cardiac surgery. Nosocomial infections strongly influencing the effectiveness of postoperative rehabilitation remain among the major problems of modern health care. Objective: To establish risk factors for infectious complications in children with congenital heart defects after cardiac surgery. Materials and methods: In 2014 to 2021, we conducted a case–control study of 603 patients under the age of 18 with congenital heart defects who underwent 643 cardiac surgeries at the perinatal center. The case cohort included 134 children of both sexes having infectious complications while the control cohort included 469 children of both sexes showing no signs of nosocomial infections after cardiac surgeries. We assessed the role of endogenous and exogenous risk factors for postoperative infectious complications and the relationship between the exposure and the outcome based on the odds ratio. Testing for significance of differences was performed by hypothesis assessment with the calculation of the p-value and estimation of confidence intervals. Results: The incidence density of healthcare-associated infections was 15.6 (13.26–18.32) per 1,000 patient-days. The most significant endogenous and exogenous risk factors were identified. Conclusions: The established predictors of infectious complications indicate the need for a risk-based approach to prevention of nosocomial infections in pediatric cardiac surgery.