title: Invasive device-related infections after heart surgery.
abstract: OBJECTIVE
  To analyze postoperative infections in critically ill patients undergoing heart surgery.
  
  
  METHODS
  Intensive care units (ICUs).
  
  
  METHODS
  An observational, prospective, multicenter study was carried out.
  
  
  METHODS
  Patients in the postoperative period of heart surgery admitted to the ICU and included in the ENVIN-HELICS registry between 2005 and 2011.
  
  
  METHODS
  Mechanical ventilation associated pneumonia (MVP), urinary catheter-related infection (UCI), primary bacteremia (PB), PB related to vascular catheters (PB-VC) and secondary bacteremia.
  
  
  RESULTS
  Of a total of 97,692 patients included in the study, 9089 (9.3%) had undergone heart surgery. In 440 patients (4.8%), one or more infections were recorded. Infection rates were 9.94 episodes of MVP per 1000 days of mechanical ventilation, 3.4 episodes of UCI per 1000 days of urinary catheterization, 3.10 episodes of BP-VC per 1000 days of central venous catheter, and 1.84 episodes of secondary bacteremia per 1000 days of ICU stay. Statistically significant risk factors for infection were ICU stay (odds ratio [OR] 1.18, 95%CI 1.16-1.20), APACHE II upon admission to the ICU (OR 1.05, 95%CI 1.03-1.07), emergency surgery (OR 1.67, 95%CI 1.13-2.47), previous antibiotic treatment (OR 1.38, 95%CI 1.04-1.83), and previous colonization by Pseudomonas aeruginosa (OR 18.25, 95%CI 3.74-89.06) or extended spectrum beta-lactamase producing enterobacteria (OR 16.97, 95%CI 5.4-53.2). The overall ICU mortality rate was 4.1% (32.2% in patients who developed one or more infections and 2.9% in uninfected patients) (P < .001).
  
  
  CONCLUSIONS
  Of the patients included in the ENVIN-HELICS registry, 9.3% were postoperative heart surgery patients. The overall mortality was low but increased significantly in patients who developed one or more infection episodes.
authors.affiliation: Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España. Electronic address: Falvarez@imas.imim.es.
authors.forename: F
authors.initials: F
authors.lastname: Álvarez Lerma
authors.forename: M
authors.initials: M
authors.lastname: Carrasco
authors.forename: J J
authors.initials: JJ
authors.lastname: Otal
authors.forename: M
authors.initials: M
authors.lastname: Palomar
authors.forename: P
authors.initials: P
authors.lastname: Olaechea
authors.forename: X
authors.initials: X
authors.lastname: Peris
authors.forename: L
authors.initials: L
authors.lastname: Iglesias
authors.forename: A
authors.initials: A
authors.lastname: Martínez Pellus
authors.forename: A
authors.initials: A
authors.lastname: Arenzana
authors.forename: J C
authors.initials: JC
authors.lastname: Ballesteros
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cirugía cardiaca; ENVIN-HELICS registry; Factores de riesgo; Heart surgery; Infecciones relacionadas con dispositivos invasivos; Invasive device-associated infections; Registro ENVIN-HELICS; Risk factors