Risk factors of sepsis after open congenital cardiac surgery in infants: a pilot study

Fakhri, Dicky; Busro, Pribadi Wiranda; Rahmat, Budi; Purba, Salomo; Mukti, Aryo A.P.; Caesario, Michael; Christy, Kelly; Santoso, Anwar; Djauzi, Samsuridjal

doi:10.13181/mji.v25i3.1450

Cited by 2 publications

(4 citation statements)

References 42 publications

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“…Fakhri et al 12 indicated in their study that the duration of CPB ≥ 90 min. was linked to a 5.538 increased risk of postsurgical sepsis in comparison to those ≤90 min.…”

Section: Discussionmentioning

confidence: 95%

“… 3 , 6 Many are surgical site infections (incidence, 2.3%–8%). 7 Some are more severe, such as septicemia (incidence, 6.3%–15%), 8 , 9 , 10 mediastinitis (incidence, 0.2%–3.3%), 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 and endocarditis (incidence, 0.2%). 11 …”

Section: Discussionmentioning

confidence: 99%

“…3,6 Many are surgical site infections (incidence, 2.3%-8%). 7 Some are more severe, such as septicemia (incidence, 6.3%-15%), 8-10 mediastinitis (incidence, 0.2%-3.3%), [6][7][8][9][10][11][12][13][14] and endocarditis (incidence, 0.2%). 11 Pollock et al 4 reported blood-stream infections (BSIs) in 21 (6.8%) out of 310 children after cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of sepsis and prevalence of multidrug‐resistant organisms in pediatric cardiac surgery in tertiary care teaching rural hospital in India: A retrospective observational study

Bhende

Pathan

Sharma

et al. 2023

Health Science Reports

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Background and aims: Cardiac surgery and cardiopulmonary bypass result in an immunoparalyzed state in children making them susceptible to sepsis and other hospital-acquired infections. Therefore, identification of the risk factors of sepsis would lead to appropriate management. The current study seeks to evaluate the prevalence of sepsis and risk factors linked to sepsis in pediatric cardiac surgical patients and the subsequent prevalence of multidrug-resistant organisms.Methods: A retrospective, single-center observational study was conducted including 100 pediatric patients admitted to the pediatric intensive care unit (ICU) after cardiac surgery between January 2017 and February 2018. All patient data were obtained from the medical record department of the hospital. Patient case report form comprised demography, surgery details, preoperative and postoperative hematological reports, and clinical details. After collecting the data, chi-square test and logistic regression analysis were used to determine the risk factors linked to sepsis. Results:The prevalence of sepsis in our population was 27% and the mortality rate due to sepsis was 1%. The only statistically significant risk factor for sepsis we discovered in this analysis was prolonged ICU stay for more than 5 days. A total of eight patients had blood cultures positive for bacterial infection. The alarming finding was that all eight were infected with multidrug-resistant organisms, demanding the last line of antibacterials. Conclusion:Our study indicates that special clinical care is required when ICU stay is prolonged to lower the risk of sepsis. These new and upcoming infections not only promote high mortality and morbidity rates but also contribute to increased cost of care due to the use of newer broad-spectrum antibiotics and longer hospital stay.The high prevalence of multidrug-resistant organisms is unacceptable in the current

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“…Fakhri et al 12 indicated in their study that the duration of CPB ≥ 90 min. was linked to a 5.538 increased risk of postsurgical sepsis in comparison to those ≤90 min.…”

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors of sepsis and prevalence of multidrug‐resistant organisms in pediatric cardiac surgery in tertiary care teaching rural hospital in India: A retrospective observational study

Bhende

Pathan

Sharma

et al. 2023

Health Science Reports

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“…NLR is a potential marker of inflammation to determine the presence of inflammation [12,13]. NLR was chosen because it is considered superior, frequently used, easy to calculate, and cheaper than other inflammatory markers [14]. However, until now, the use of NLR as a predictor in determining LCOS has not been widely reported.…”

Section: Original Articlementioning

confidence: 99%

Neutrophil-to-lymphocyte ratio as a predictor of low cardiac output syndrome after open heart surgery in children with congenital heart disease

Laila,

Perdana,

Permatasari

et al. 2024

Narra J

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Neutrophil-to-lymphocyte ratio (NLR) as a predictor in determining low cardiac output syndrome (LCOS) has not been widely reported. The aim of this study was to explore the role of pre-surgery, 0-, 4-, and 8-hour post-surgery NLR as predictors of LCOS incidence after open heart surgery in children with congenital heart disease (CHD). This study used a prognostic test with a prospective cohort design and was conducted from December 2020 until June 2021 at the cardiac intensive care unit (CICU) of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The subject consisted of children aged one month to 18 years who underwent open heart surgery using a cardiopulmonary bypass (CPB) machine. A receiver operating characteristic curve was applied to identify the predictive performance of NLR for poor outcomes (LCOS incidence). Out of 90 patients included in the study, 25 (27.8%) of them developed LCOS between 3 to 53 hours post-surgery. All NLR values (pre-surgery and 0-, 4-, and 8-hours post-surgery) were associated with the incidence of LCOS. Pre-surgery NLR (cut-off value ≥0.88) had a fair predictive value (area under curve (AUC) 70; 95%CI: 57–83) for predicting LCOS incidence with sensitivity and specificity of 64% and 64.62%, respectively. NLR 0-hour post-surgery (cut-off value ≥4.73) had a good predictive value (AUC 81; 95%CI: 69–94) for predicting LCOS incidence, with 80% sensitivity and 80% specificity. NLR 4- and 8-hours post-surgery had very good predictive values (AUC 97%; 95%CI: 92–100 and 98; 95%CI: 94–100, respectively), with cut-off values ≥6.19 and ≥6.78, had the same 92% sensitivity and the same 96% sensitivity. The presence of LCOS was associated with mortality (odds ratio of 5.11 with 95%CI: 3.09–8.46). This study highlights that pre-surgery, 0-, 4-, and 8-hours post-surgery NLR can be predictors of LCOS after open heart surgery in children with CHD.

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Risk factors of sepsis after open congenital cardiac surgery in infants: a pilot study

Cited by 2 publications

References 42 publications

Risk factors of sepsis and prevalence of multidrug‐resistant organisms in pediatric cardiac surgery in tertiary care teaching rural hospital in India: A retrospective observational study

Risk factors of sepsis and prevalence of multidrug‐resistant organisms in pediatric cardiac surgery in tertiary care teaching rural hospital in India: A retrospective observational study

Neutrophil-to-lymphocyte ratio as a predictor of low cardiac output syndrome after open heart surgery in children with congenital heart disease

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