title: Impact of hospital infections on patients outcomes undergoing cardiac surgery at Santa Casa de Misericórdia de Marília.
abstract: OBJECTIVE
  This study aimed to determine the incidence of nosocomial infections, the risk factors and the impact of these infections on mortality among patients undergoing to cardiac surgery.
  
  
  METHODS
  Retrospective cohort study of 2060 consecutive patients from 2006 to 2012 at the Santa Casa de Misericórdia de Marília.
  
  
  RESULTS
  351 nosocomial infections were diagnosed (17%), 227 non-surgical infections and 124 surgical wound infections. Major infections were mediastinitis (2.0%), urinary tract infection (2.8%), pneumonia (2.3%), and bloodstream infection (1.7%). The in-hospital mortality was 6.4%. Independent variables associated with non-surgical infections were age > 60 years (OR 1.59, 95% CI 1.09 to 2.31), ICU stay > 2 days (OR 5, 49, 95% CI 2.98 to 10, 09), mechanical ventilation > 2 days (OR11, 93, 95% CI 6.1 to 23.08), use of urinary catheter > 3 days (OR 4.85 95% CI 2.95 -7.99). Non-surgical nosocomial infections were more frequent in patients with surgical wound infection (32.3% versus 7.2%, OR 6.1, 95% CI 4.03 to 9.24). Independent variables associated with mortality were age greater than 60 years (OR 2.0; 95% CI 1.4 t o3.0), use of vasoactive drugs (OR 3.4, 95% CI 1.9 to 6, 0), insulin use (OR 1.8; 95% CI 1.2 to 2.8), surgical reintervention (OR 4.4; 95% CI 2.1 to 9.0) pneumonia (OR 4.3; 95% CI 2.1 to 8.9) and bloodstream infection (OR = 4.7, 95% CI 2.0 to 11.2).
  
  
  CONCLUSIONS
  Non-surgical hospital infections are common in patients undergoing cardiac surgery; they increase the chance of surgical wound infection and mortality.
authors.affiliation: Hospital Infection at University of Ottawa, Ottawa, Canada.
authors.forename: Lucieni Oliveira
authors.initials: LO
authors.lastname: Conterno
authors.affiliation: Hospital Infection Control Service, Santa Casa de Misericordia de Marília, Marília, SP, Brazil.
authors.forename: Silvana Martins Dias
authors.initials: SM
authors.lastname: Toni
authors.affiliation: Hospital Infection Control Service, Santa Casa de Misericordia de Marília, Marília, SP, Brazil.
authors.forename: Rubiana Gonçalves
authors.initials: RG
authors.lastname: Konkiewitz
authors.affiliation: Hospital Infection Control Service, Santa Casa de Misericordia de Marília, Marília, SP, Brazil.
authors.forename: Elaine Salla
authors.initials: ES
authors.lastname: Guedes
authors.affiliation: University of Campinas, Campinas, SP, Brazil.
authors.forename: Rubens Tofano de
authors.initials: RT
authors.lastname: Barros
authors.affiliation: Hospital Santa Casa de Misericordia de Marília, Marília, SP, Brazil.
authors.forename: Marcos Gradim
authors.initials: MG
authors.lastname: Tiveron
mesh_terms: D000367:Age Factors; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D003428:Cross Infection / Q000150:complications / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000150:complications / Q000401:mortality; D013997:Time Factors