Original articlePediatric cardiacMajor Infection After Pediatric Cardiac Surgery: A Risk Estimation Model
Section snippets
Data Source
The Society of Thoracic Surgeons Congenital Heart Surgery Database was founded in 2002 to support quality improvement in heart surgery. Data elements include demographic information, cardiac and noncardiac anomalies, comorbid conditions, type of operation, and outcomes including in-hospital mortality, major complications, and length of stay. We obtained approval from the Duke Institutional Review Board for waiver of consent on the basis of the unidentified nature of the data.
Patient Population
We evaluated
Demographic Characteristics and Infection
We analyzed a total of 30,078 cases in the Society of Thoracic Surgeons Congenital Cardiac Surgery Database. From this cohort, 857 patients (2.8%) had major infection (2.6% septicemia, 0.3% mediastinitis, 0.09% endocarditis). Thirty-two patients had more than one type of infection. Of patients with major infection, the mean age was 6.5 months (versus 2.4 years for the entire cohort). Fifty-five percent of patients were male in both the entire cohort and in those with major infection. Both
Comment
Our study confirms that major infection after congenital heart surgery is a complication with significant sequelae. Using a large multicenter patient population, we identified risk factors for major infection and created a clinical tool that can be used preoperatively to estimate a patient's infection risk. We validated the model internally showing that it has good discrimination.
Previous studies have evaluated risk factors for specific types of postoperative infections. Cardiopulmonary bypass,
References (30)
- et al.
Nosocomial infections in pediatric patients following cardiac surgery
An Pediatr (Barc)
(2008) - et al.
Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors
J Hosp Infect
(2003) - et al.
Risk factors for surgical site infections following open-heart surgery in a Canadian pediatric population
Am J Infect Control
(2004) - et al.
Bloodstream infections after median sternotomy at a children's hospital
J Thorac Cardiovasc Surg
(2007) - et al.
Mediastinitis after pediatric cardiac surgery: a 15-year experience at a single institution
Ann Thorac Surg
(2003) - et al.
Determinants of early outcome after neonatal cardiac surgery in a developing country
J Thorac Cardiovasc Surg
(2007) Mediastinal wound infections following pediatric cardiac surgery
Semin Thorac Cardiovasc Surg
(2004)- et al.
Consensus-based method for risk adjustment for surgery for congenital heart disease
J Thorac Cardiovasc Surg
(2002) - et al.
Prospective incidence study of nosocomial infections in a pediatric intensive care unit
Pediatr Infect Dis J
(2003) - et al.
Nosocomial infections in pediatric cardiac surgery, Italy
Infect Control Hosp Epidemiol
(2001)
Early nosocomial infections in pediatric cardiovascular surgery patients
Crit Care Med
Risk factors for sternal wound and other infections in pediatric cardiac surgery patients
Pediatr Infect Dis J
Infection risk factors in pediatric cardiac surgery
Asian Cardiovasc Thorac Ann
Risk factors for surgical site infections after pediatric cardiovascular surgery
Pediatr Infect Dis J
Mediastinitis in pediatric cardiac surgery: treatment and cost-effectiveness in a low-income country
Pediatr Cardiol
Cited by (107)
Antibiotic Stewardship in Pediatrics
2021, Advances in PediatricsSocioeconomic Influences on Outcomes Following Congenital Heart Disease Surgery
2024, Pediatric CardiologyEarly Wound and Sternal Management Following Pediatric Cardiac Surgery
2024, World Journal for Pediatric and Congenital Heart Surgery