Ricardo Bou, Conso Merino, Ignacio Rodriguez, Fany Hervás, Aurora Amorós and Belen Viñals
Background: Surgical site infections can be a severe complication associated with an increase in mortality following coronary artery bypass graft surgery. We performed a study to determine risk factors for the development of SSI and to set up prevention strategies in the management of these patients. Methods: Case-control study at a 302-bed, teaching hospital. Case-patients with surgical-site infection occurring up to 1 month following coronary artery bypass grafting performed between January 2000 and December 2010 were identified prospectively by hospital epidemiologist using National Nosocomial Infections Surveillance (NNIS) System methods. Two control-patients were selected for each case-patient, matched by date of surgery. Results: Eighty-seven patients with infections (65 superficial and 22 deep) were identified. Logistic regression analysis identified tree variables independently associated with the development of infection: diabetes mellitus (OR, 1.9; 95% confidence interval [95% CI], 1.0 to 3.8.; P = 0.05), a NYHA class IV score (OR, 3.4; 95% CI, 1.8 to 8.4; P = 0.0001) and the use of surgical drains (OR, 1.2; 95% CI, 1.1 to 1.4; P = 0.0001). Factors not statistically associated with the development of infection included age, NNIS System risk index score, presence of various co morbidities, surgeon, duration and type of procedure, or other invasive procedures. Conclusion: The use of closed suction drainage, diabetes mellitus and a high NYHA score were associated with the development of surgical-site infection following coronary artery bypass grafting. Avoiding the use of surgical drains and careful monitoring of blood glucose in patients undergoing coronary artery bypass grafting should reduce the risk of infection.
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