title: Surgical Site Infection After Pediatric Cardiothoracic Surgery.
abstract: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS.
  
  
  
  We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure.
  
  
  
  Of the 981 cases performed during the study period, 12 with SSI were identified. There were no differences in demographics, clinical characteristics, or intraoperative data. Median total hospital costs were higher in participants with SSI as compared to controls (US$219,573 vs US$82,623, P < .01). Children with SSI had longer median CICU length of stay (9 vs 3 days, P < .01), hospital length of stay (18 vs 8.5 days, P < .01), and duration of mechanical ventilation (2 vs 1 day, P < .01) and vasoactive administration (4.5 vs 1 day, P < .01).
  
  
  
  Children with SSI after CTS have an associated increase in hospital costs of US$136,950/case and hospital length of stay of 9.5 days/case. The economic burden posed by SSI stress the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.
authors.affiliation: 1 Division of Critical Care Medicine, Department of Pediatrics, Johns Hopkins All Children's Hospital, St Petersburg, FL, USA.|2 School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Sochet
authors.affiliation: 3 Division of Critical Care Medicine, Department of Pediatrics, Children's National Health System, Washington, DC, USA.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Cartron
authors.affiliation: 2 School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
authors.forename: Aoibhinn
authors.initials: A
authors.lastname: Nyhan
authors.affiliation: 4 Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Spaeder
authors.affiliation: 2 School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.|5 Division of Infectious Disease, Department of Pediatrics, Children's National Health System, Washington, DC, USA.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Song
authors.affiliation: 2 School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.|6 Division of Anesthesiology, Department of Pediatrics, Children's National Health System, Washington, DC, USA.
authors.forename: Anna T
authors.initials: AT
authors.lastname: Brown
authors.affiliation: 2 School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.|7 Division of Cardiology, Department of Pediatrics, Children's National Health System, Washington, DC, USA.
authors.forename: Darren
authors.initials: D
authors.lastname: Klugman
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
keywords: complications; congenital heart surgery; cost analysis; health economics; intensive care; patient safety; surgery; wound infection