The Role of Patient’s Profile and Allogeneic Blood Transfusion in Development of Post-Cardiac Surgery Infections: A Retrospective Study
OBJECTIVES:
We aimed to investigate the
association of patient characteristics and allogeneic blood transfusion
products in development of post-cardiac surgery nosocomial infections.
METHODS:
This
retrospective study was conducted in 7888 patients undergoing cardiac
surgery with median sternotomy and cardiopulmonary bypass. Multivariable
logistic regression analysis was used for independent effect of
variables on infections.
RESULTS:
A total of 970 (12.3%)
patients developed one or several types of postoperative infections.
Urinary (n = 351, 4.4%) and pulmonary tract infections (n = 478, 6.1%)
occurred more frequently than sternal wound infections (superficial: n=
102, 1.3%, deep: n = 72, 0.9%) and donor site infections (n= 61, 0.8%).
Interventions, including valve replacement (P = 0.002) and coronary
artery bypass grafting combined with valve replacement (P= 0.012), were
associated with increased risk of several types of postoperative
infections. Patients’ profiles changed substantially over the years;
morbid obesity (P= 0.019), smoking (P= 0.001) and diabetes mellitus (P=
0.001) occur more frequently nowadays. Furthermore, surgical site
infections showed to be related to morbid obesity (P< 0.001) and
higher risk stratification (P= 0.031). Smoking (P < 0.001) and
chronic obstructive pulmonary disease (P < 0.001) were related to
pulmonary tract infections. In addition, diabetic patients developed
more sepsis (P = 0.003) and advanced age was associated with development
of urinary tract infections (P < 0.001). Even after correcting for
other factors, blood transfusion was associated with all types of
postoperative infection (P < 0.001). This effect remained present in
both leucocyte-depleted and non-leucocyte-depleted transfusion.
CONCLUSIONS:
Our
data showed that post-cardiac surgery infections occur more frequently
in patients with predetermined risk factors. The amount of blood
transfusions was integrally related to every type of postoperative
infection.
