Email this article Comparative assessment of the frequency and risk factors of purulent-septic infections in adult patients after various types of open and closed heart surgery
- Authors: Sergevnin V.I.1, Kudryavtseva L.G.2
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Affiliations:
- Perm State Medical University Ministry of Health of Russian Federation
- Cardiovascular Surgery Federal Center named after S.G. Sukhanov Ministry of Health of the Russian Federation
- Issue: Vol 25, No 2 (2020)
- Pages: 78-87
- Section: ORIGINAL STUDIES
- URL: https://journals.rcsi.science/1560-9529/article/view/34993
- DOI: https://doi.org/10.17816/EID34993
- ID: 34993
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Abstract
BACKGROUND: The widespread increase in the number and types of cardiac surgery necessitate the study of frequency and risk factors of postoperative purulent-septic infections (PSIs).
AIM: to provide a comparative assessment of the PSI frequency and risk factors in adult patients after various types of cardiac surgery.
MATERIALS AND METHODS: Based on the cardiac surgery hospital materials, medical records of 4.815 patients over 18 years of age, who underwent open (n = 1.540) and closed (n = 3.275) heart surgeries within 1 year, were analyzed. The typical and prenosological forms of PSIs were taken into account in accordance with the epidemiological standard of case definition.
RESULTS: The incidence rates for typical and prenosological PSI forms amounted to 39.6 and 72.7 per 1000 surgeries after open heart surgery, respectively, and 3.1 and 3.9 after minimally invasive endovascular surgical interventions, respectively. The main clinical forms of PSI after open and closed heart surgeries were surgical site infections, nosocomial pneumonia, urinary tract infection, and bloodstream infection. In an open heart surgery, the maximum incidence rates for typical and prenosological forms of PSIs were recorded after surgeries on the aorta and less often after heart valve replacement or coronary artery bypass grafting. The increased incidence rate after aortic surgery was mainly due to urinary tract infection and nosocomial pneumonia. In the case of closed heart surgery, no statistically significant differences were detected between the incidence rates of PSIs after coronary artery stenting, cardiac arrhythmia and carotid artery stenosis surgery, and other interventions. The duration of both the surgery itself and the subsequent patient stay in the intensive care unit was found to be important as risk factors for PSIs after cardiac surgery.
CONCLUSION: The incidence rate of PSIs after open heart surgery is significantly higher than after closed heart surgery, which is mostly associated with the duration of surgical intervention and the subsequent patient stay in the intensive care unit.
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##article.viewOnOriginalSite##About the authors
Victor I. Sergevnin
Perm State Medical University Ministry of Health of Russian Federation
Email: viktor-sergevnin@mail.ru
ORCID iD: 0000-0002-2729-2248
Dr. Sci. (Med.), professor of the department of Epidemiology and Hygiene
Russian Federation, 614990, Perm, Petropavlovskaya str.,26Larisa G. Kudryavtseva
Cardiovascular Surgery Federal Center named after S.G. Sukhanov Ministry of Health of the Russian Federation
Author for correspondence.
Email: Kudryavcevalg@mail.ru
ORCID iD: 0000-0002-2707-0768
candidate of medicine, head of the epidemiological department – epidemiologist
Russian Federation, 614013 ,Perm, Marshal Zhukov str., 35, RussiaReferences
- Bokeriya LA, Gudkova RG. Serdechno-sosudistaya khirurgiya-2011. Bolezni i vrozhdennyye anomalii sistemy krovoobrashcheniya. Мoscow: NTSSSKH im. A.N. Bakuleva RAMN; 2012. 196 р. (In Russ.)
- Alekyan B.G., Grigoryan A.M., Staferov A.V., Karapetyan N.G. Endovascular diagnostics and treatment in the Russian Federation (2017). Russian journal of endovascular surgery. 2018;5(2):93-240. (In Russ). doi: 10.24183/2409-4080-2018-5-2-93-240.
- Bakhronov ShR. Razvitiye endovaskulyarnykh metodov lecheniya ser’yeznykh zabolevaniy serdechno-sosudistoy sistemy cheloveka i analiz vozmozhnykh oslozhneniy. Avitsenna. 2018;(21):32-41. (In Russ).
- Aref’eva LI, Gorskaya EM, Savostyanova OA, et al. The infectious complications of bacterial nature in cardio-vascular surgery. Medical Journal of the Russian Federation. 2013;(3):36-42. (In Russ).
- Kazachek YV, Pomeshkina SA, Barbarash OL. Prevention of infectious complications in cardiac surgery. Complex Issues of Cardiovascular Diseases. 2014;(4):62-69. (In Russ). doi: 10.17802/2306-1278-2014-4-62-69.
- Popov DA. Postoperative infectious complications in cardiac surgery. Annaly khirurgii. 2013;(5):15-21. (In Russ).
- Nastas AF. Epidemiologiya vnutribol’nichnykh gnoyno-septicheskikh infektsiy u posleoperatsionnykh kardiokhirurgicheskikh patsiyentov. Nauchnyye gorizonty. 2018;(2):201-217. (In Russ).
- O’Keefe S, Williams K, Legare JF. Hospital-acquired infections after cardiac surgery and current physician practices: a retrospective cohort study. J Clin Med Res. 2017;9(1):10-16. doi: 10.14740/jocmr2637w.
- Gabrielyan NI. Gnoyno-septicheskiye oslozhneniya v transplantologii i kardiokhirurgii: epidemiologiya i profilaktika. [dissertation abstract] Moscow; 2011. 47 р. (In Russ). Available from: https://search.rsl.ru/ru/record/01004852215
- Sazhin AV, Tyagunov AE, Nechay TV, et al. The diagnostics and treatment of purulent complications in area of implanted electric cardiostimulator. Medical Journal of the Russian Federation. 2013;(1):41-45. (In Russ).
- Johansen JB, Jorgensen OD, Møller M, et al. Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients. Eur Heart J. 2011;32(8):991-998. doi: 10.1093/eurheartj/ehq497.
- Kusumoto FM, Schoenfeld MH, Wilkoff BL, et al. 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. Heart Rhythm. 2017;14(12):e503-551. doi: 10.1016/j.hrthm.2017.09.001.
- Lekkerkerker JC, van Nieuwkoop C, Trines SA, et al. Risk factors and time delay associated with cardiac device infections: Leiden device registry. Heart. 2009;95(9):715-720. doi: 10.1136/hrt. 2008.151985.
- European Centre for Disease Prevention and Control. Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals – protocol version 4.3. Stockholm: ECDC; 2012. https://www.ecdc.europa.eu/en/publications-data/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use
- Sergevnin VI, Klyuchareva NM. Pre-epidemic diagnosis of hospital-acquired purulent-septic infections’’ morbidity. Population health and life environment. 2018;(1):27-29. (In Russ). doi: 10.35627/2219-5238/2018-298-1-27-29.
- Rudnov VA, Zubarev AS. Infektsii v otdelenii reanimatsii i intensivnoy terapii, vyzvannyye P. aeruginosa i Acinetobacter spp. Consilium Medicum. 2008;10(1):37-44. (In Russ).
- Sergevnin VI, Klyuchareva NM. Epidemic process manifestation of purulent-septic infections among patients of resuscitation and department of intensive therapy general hospitals and antibiotic susceptibility. Epidemiology & Vaccinal prevention. 2013;(1):23-29. (In Russ).
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