Determinants and Early Outcomes of Surgical Site Infection Following Cardiac Surgery: A Prospective Cohort Study
David B. Idowu, Anbarasu Mohanraj, Anusha Karunasagar, Ezekiel O. Ogunleye, Jide M. AfolayanAbstract
Background:
Surgical site infection (SSI) remains an important cause of postoperative morbidity after heart procedures and is associated with prolonged recovery and increased healthcare utilisation. Prospective data evaluating both determinants and early postoperative impacts within the same cohort are limited.
Materials and Methods:
A prospective cohort study was conducted on 271 consecutive patients who underwent heart procedures at Institutes of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India, a tertiary cardiac centre. Procedures included surgical myocardial revascularisation, valvular intervention, congenital cardiac procedures and combined surgeries. SSI surveillance was performed for 30 days using Centers for Disease Control and Prevention criteria. Logistic regression analysis was used to evaluate predictors of infection. Postoperative outcomes, including reintubation, re-exploration, blood transfusion, hospital stay and in-hospital mortality, were compared between patients with and without SSI.
Results:
SSI developed in 24 patients, yielding an incidence of 8.9%. Severe ventricular dysfunction (left ventricular ejection fraction <35%) remained independently associated with infection following multivariable adjustment (adjusted odds ratio = 4.11, 95% confidence interval: 1.31–12.9,
Conclusion:
SSI is a clinically significant complication of cardiac surgery. Severe ventricular dysfunction was the strongest independent predictor of infection in this cohort study. Patients with severe ventricular dysfunction may benefit from closer perioperative surveillance and postoperative optimisation.