Olsen Margaret A, Sundt Thoralf M, Lawton Jennifer S, Damiano Ralph J, Hopkins-Broyles Diane, Lock-Buckley Patricia, Fraser Victoria J
Washington University School of Medicine, Division of Infectious Diseases, 660 South Euclid Ave, Campus Box 8051, St Louis, MO 63110-1093, USA.
J Thorac Cardiovasc Surg. 2003 Oct;126(4):992-9. doi: 10.1016/s0022-5223(03)00200-9.
Harvest site infections are more common than chest surgical infections after coronary artery bypass surgery, yet few studies detail risk factors for these infections. We sought to determine independent risk factors for leg surgical site infections using our institutional Society of Thoracic Surgeons database.
We retrospectively analyzed data collected from 1980 coronary artery bypass patients undergoing surgery at our institution from January 1, 1996, through June 30, 1999, using The Society of Thoracic Surgeons database. Independent risk factors for leg harvest site infection were identified by multivariate logistic regression.
Seventy-six patients (4.5%) were coded as having had a leg harvest site infection, of which 67 were confirmed by infection control. The length of hospital stay after surgery was significantly longer in patients with leg harvest site infection (mean 10.1 days) compared with that of patients without infection (mean 7.1 days, P <.001), and infected patients were more likely to be readmitted to the hospital within 30 days of surgery. Independent risk factors for leg harvest site infection included previous cerebrovascular accident (odds ratio, 2.9), postoperative transfusion of 5 units or more of red blood cells (odds ratio, 2.8), obesity (odds ratio, 2.5), age 75 years or older (odds ratio, 1.9), and female gender (odds ratio, 1.8).
Consistent with previous studies, female gender and obesity were identified as independent risk factors for leg harvest site infection, while previous cerebrovascular accident, postoperative transfusion, and older age are newly described risk factors. The Society of Thoracic Surgeons database is a useful tool for identification of predictors of leg harvest site infections.
在冠状动脉搭桥手术后,腿部取血管部位感染比胸部手术感染更为常见,但很少有研究详细阐述这些感染的危险因素。我们试图利用我们机构的胸外科医师协会数据库来确定腿部手术部位感染的独立危险因素。
我们回顾性分析了1996年1月1日至1999年6月30日期间在我们机构接受手术的1980例冠状动脉搭桥患者的数据,这些数据来自胸外科医师协会数据库。通过多因素逻辑回归确定腿部取血管部位感染的独立危险因素。
76例患者(4.5%)被编码为发生了腿部取血管部位感染,其中67例经感染控制得到证实。腿部取血管部位感染患者术后住院时间(平均10.1天)显著长于未感染患者(平均7.1天,P<.001),且感染患者在术后30天内更有可能再次入院。腿部取血管部位感染的独立危险因素包括既往脑血管意外(比值比,2.9)、术后输注5单位或更多单位红细胞(比值比,2.8)、肥胖(比值比,2.5)、75岁及以上年龄(比值比,1.9)和女性(比值比,1.8)。
与先前的研究一致,女性和肥胖被确定为腿部取血管部位感染的独立危险因素,而既往脑血管意外、术后输血和高龄是新发现的危险因素。胸外科医师协会数据库是识别腿部取血管部位感染预测因素的有用工具。