title: Outcome and risk factors associated with surgical site infections after cardiac surgery in a Taiwan medical center.
abstract: OBJECTIVE
  Surgical site infection (SSI) after cardiac surgery leads to morbidity and mortality. Identifying SSI risk factors, which vary between populations, is important in preventing infection.
  
  
  METHODS
  A retrospective chart review of adult cases receiving cardiac surgery in a Taiwan medical center in 2004 and 2005.
  
  
  RESULTS
  Of the 260 cases included in the study, 169 (65.0%) received a coronary artery bypass graft, 65 (25.0%) cardiac valvular surgery and 26 (10.0%) aortic or septal defect operations. The SSI rate was 13.5%. Univariate analysis showed that chronic obstructive pulmonary disease (COPD) (p = 0.008), congestive heart failure New York Heart Association class IV (p = 0.048), longer preoperative hospital stay, preoperative nosocomial infection, higher volume of blood loss and larger packed red blood cell transfusions during the operation were significantly related to SSI. Logistic regression analysis further identified COPD, pre-operative nosocomial infection and emergency surgery as being independently associated with SSI (odds ratios of 4.96, 5.88 and 9.77, respectively). Obesity and diabetes mellitus were not associated with SSI.
  
  
  CONCLUSIONS
  COPD is an independent underlying illness associated with SSI after cardiac surgery. Minimizing preoperative hospitalization and nosocomial infection, and awareness of cases presenting with relevant risk factors, are useful in reducing SSI.
authors.affiliation: Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Pei
authors.initials: YP
authors.lastname: Lee
authors.forename: Ming-Chu
authors.initials: MC
authors.lastname: Feng
authors.forename: Ling-Chu
authors.initials: LC
authors.lastname: Wu
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Chen
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
authors.forename: Chaw-Chi
authors.initials: CC
authors.lastname: Chiu
authors.forename: Tun-Chieh
authors.initials: TC
authors.lastname: Chen
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003428:Cross Infection / Q000150:complications; D005260:Female; D006343:Heart Septal Defects / Q000601:surgery; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D013624:Taiwan; D016896:Treatment Outcome