Risk Factors for Surgical Site Infection in Patients Undergoing Pediatric Cardiac Surgery.

Autor: Ribeiro ACL; Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Cardiologia Pediátrica e Cardiopatias Congênitas do Adulto, São Paulo , SP - Brasil., Siciliano RF; Equipe de Controle de Infecção - Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil., Lopes AA; Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Cardiologia Pediátrica e Cardiopatias Congênitas do Adulto, São Paulo , SP - Brasil., Strabelli TMV; Equipe de Controle de Infecção - Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil.
Jazyk: Portuguese; English
Zdroj: Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2023 Dec; Vol. 120 (12), pp. e20220592.
DOI: 10.36660/abc.20220592
Abstrakt: Background: Central Illustration : Risk Factors for Surgical Site Infection in Patients Undergoing Pediatric Cardiac Surgery Risk factors for surgical site infection in patients undergoing pediatric cardiac surgery.
Background: Surgical site infection is an important complication after pediatric cardiac surgery, associated with increased morbidity and mortality.
Objectives: We sought to identify risk factors for surgical site infection after pediatric cardiac surgeries.
Methods: A case-control study included patients aged between 1 year and 19 years and 11 months of age, submitted to cardiac surgery performed at a tertiary cardiac center from January 1 st , 2011, through December 31, 2018. Charts were reviewed for pre-, intra, and postoperative variables. We identified two randomly selected control patients with the same pathophysiological diagnosis and underwent surgery within thirty days of each index case. Univariate and multivariate logistic regression analyses were performed to identify risk factors. Statistical significance was defined as p<0.05.
Results: Sixty-six cases and 123 controls were included. Surgical site infection incidence ranged from 2% to 3.8%. The following risk factors were identified: Infant age (OR 3.19, 95% CI 1.26 to 8.66, p=0.014), presence of genetic syndrome (OR 6.20, CI 95% 1.70 to 21.65, p=0.004), categories 3 and 4 of RACHS-1 (OR 8.40, CI 95% 3.30 to 21.34, p<0.001), 48 h C-reactive protein level range was detected as a protective factor for this infection (OR 0.85, 95% CI 0.73 to 0.98, p=0.023).
Conclusions: The risk factors defined in this study could not be modified. Therefore, additional surveillance and new preventive strategies need to be implemented to reduce the incidence of surgical site infection. The increased CRP in the postoperative period was a protective factor that needs further understanding.
Databáze: MEDLINE