Mao Guangxu, Chen Wensen, Wang Liyun, Zhao Sheng, Zang Feng
Department of Infection Management, Xinghua People's Hospital Affiliated to Yangzhou University, Xinghua, Jiangsu, China.
Department of Infection Management, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Infect Prev Pract. 2025 Apr 8;7(2):100458. doi: 10.1016/j.infpip.2025.100458. eCollection 2025 Jun.
Postoperative infection remains a serious problem for patients undergoing open-heart surgery and is associated with poor prognosis and mortality.
To determine the incidence, characteristics and associated risk factors for nosocomial infections in adult cardiac surgery patients and to develop a nomogram prediction model.
Data were retrospectively collected from patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) at a tertiary hospital in 2023. Patients were divided into an infected group ( = 130) and a non-infected group ( = 192). Multivariate logistic regression analysis was used to analyse the independent risk factors for healthcare-associated infections after cardiac surgery under CPB.
Of the 1584 patients, 130 (8.21%) developed postoperative infections (infection group). Lower respiratory tract was the most common site of infection ( = 74, 56.9%), while Gram-negative bacteria were the predominant isolates overall ( = 81, 62.3%). Among the Gram-negative bacteria, was the most frequently identified, whereas was the leading strain among Gram-positive bacteria. Multivariate logistic regression analysis of the 322 patients included in the study revealed that CPB duration, American Society of Anaesthesiologists score, procalcitonin concentration on the first postoperative day, monocyte:lymphocyte ratio, preinfection mechanical ventilation duration, and preinfection central venous catheterization duration were the six independent predictors of postoperative infection. The area under the receiver operating characteristic curve was 0.824 (0.778-0.870), and the model showed good predictive performance.
A nomogram has been developed to predict postoperative infection via commonly available data. This tool could assist clinicians in optimising the perioperative care of patients undergoing cardiac surgery with CPB, but further external validation is needed.
术后感染仍是接受心脏直视手术患者面临的严重问题，且与预后不良和死亡率相关。
确定成人心脏手术患者医院感染的发生率、特征及相关危险因素，并建立列线图预测模型。
回顾性收集2023年在一家三级医院接受体外循环（CPB）心脏手术患者的数据。患者分为感染组（n = 130）和非感染组（n = 192）。采用多因素logistic回归分析CPB心脏手术后医疗相关感染的独立危险因素。
1584例患者中，130例（8.21%）发生术后感染（感染组）。下呼吸道是最常见的感染部位（n = 74，56.9%），而革兰阴性菌是总体上的主要分离菌株（n = 81，62.3%）。在革兰阴性菌中，[具体细菌名称]最常被鉴定出来，而[具体细菌名称]是革兰阳性菌中的主要菌株。对纳入研究的322例患者进行多因素logistic回归分析显示，CPB持续时间、美国麻醉医师协会评分、术后第1天降钙素原浓度、单核细胞:淋巴细胞比值、感染前机械通气时间和感染前中心静脉置管时间是术后感染的六个独立预测因素。受试者工作特征曲线下面积为0.824（0.778 - 0.870），该模型显示出良好的预测性能。
已开发出一种列线图，可通过常用数据预测术后感染。该工具可协助临床医生优化接受CPB心脏手术患者的围手术期护理，但需要进一步的外部验证。
