scholarly journals Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

2019 ◽  
Author(s):  
Xindi Yu ◽  
Maolin Chen ◽  
Xu Liu ◽  
Yiwei Chen ◽  
Zedong Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infection ◽  
Congenital Heart ◽  
Medical Center ◽  
Multivariate Logistic Regression Analysis ◽  
Infection Rates ◽  
Baseline Characteristics

Abstract Background: The aim of our study was to analyze the risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease (CHD). Methods: We performed a retrospective cohort study, and children with CHD who underwent open-heart surgeries at Shanghai Children’s Medical Center from January 1, 2012 to December 31, 2018 were included. The baseline characteristics of these patients of different ages, including neonates (0-1 months old), infants (1-12 months old) and children (1-10 years old), were analyzed, and the association of risk factors with postoperative nosocomial infection were assessed. Results: A total of 11937 subjects were included in the study. The overall nosocomial infection rate was 11.10%. Nosocomial infection rates in neonates, infants, and children with congenital heart disease were 25.41%, 15.78%, and 5.31%, respectively. Multivariate logistic regression analysis found age (OR 0.804, 95%CI: 0.776-0.834; P<0.001), STS risk grade (OR 1.308, 95%CI: 1.203-1.423; P<0.001), body mass index (BMI)

scholarly journals Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

2019 ◽  
Author(s):  
Xindi Yu ◽  
Maolin Chen ◽  
Xu Liu ◽  
Yiwei Chen ◽  
Zedong Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infection ◽  
Congenital Heart ◽  
Medical Center ◽  
Multivariate Logistic Regression Analysis ◽  
Baseline Characteristics ◽  
Risk Grade

Abstract Background: The aim of our study was to analyze the risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease (CHD). Methods: We performed a retrospective cohort study, and children with CHD who underwent open-heart surgeries at Shanghai Children’s Medical Center from January 1, 2012 to December 31, 2018 were included. The baseline characteristics of these patients of different ages, including neonates (0-1 months old), infants (1-12 months old) and children (1-10 years old), were analyzed, and the association of risk factors with postoperative nosocomial infection were assessed. Results: A total of 11651 subjects were included in the study. The overall nosocomial infection rate was 10.8%. Nosocomial infection rates in neonates, infants, and children with congenital heart disease were 32.9%, 15.4%, and 5.2%, respectively. Multivariate logistic regression analysis found age (OR 0798, 95%CI: 0.769-0.829; P<0.001), STS risk grade (OR 1.267, 95%CI: 1.159-1.385; P<0.001), body mass index (BMI) <5th percentile (OR 1.295, 95%CI: 1.023-1.639; P=0.032), BMI ＞95th percentile (OR 0.792, 95%CI: 0.647-0.969; P=0.023), cardiopulmonary bypass (CPB) time (OR 1.008, 95%CI: 1.003-1.012; P<0.001) and aortic clamping time （OR 1.009, 1.002-1.015; P = 0.008）were significantly associated with nosocomial infection in CHD infants. After adjusted for confounding factors, we found STS risk grade (OR 1.38, 95%CI: 1.167-1.633; P<0.001), BMI<5th percentile (OR 1.934, 95%CI: 1.377-2.715; P<0.001), CPB time (OR 1.018, 95%CI: 1.015-1.022; P<0.001), lymphocyte/WBC ratio﹤cut off value (OR 3.818, 95%CI: 1.529-9.533; P=0.004) and AST＞cut off value (OR 1.546, 95%CI: 1.119-2.136; P=0.008) were significantly associated with nosocomial infection in CHD children. Conclusion: Our study suggested STS risk grade, BMI, CPB duration, low lymphocyte/WBC or high neutrophil/WBC ratio were independently associated with nosocomial infection in CHD infant and children after cardiac surgery.

scholarly journals Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

2019 ◽  
Author(s):  
Xindi Yu ◽  
Maolin Chen ◽  
Xu Liu ◽  
Yiwei Chen ◽  
Zedong Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infection ◽  
Congenital Heart ◽  
Medical Center ◽  
Multivariate Logistic Regression Analysis ◽  
Baseline Characteristics ◽  
Risk Grade

Abstract Background: The aim of our study was to analyze the risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease (CHD). Methods: We performed a retrospective cohort study, and children with CHD who underwent open-heart surgeries at Shanghai Children’s Medical Center from January 1, 2012 to December 31, 2018 were included. The baseline characteristics of these patients of different ages, including neonates (0-1 months old), infants (1-12 months old) and children (1-10 years old), were analyzed, and the association of risk factors with postoperative nosocomial infection were assessed. Results: A total of 11651 subjects were included in the study. The overall nosocomial infection rate was 10.8%. Nosocomial infection rates in neonates, infants, and children with congenital heart disease were 32.9%, 15.4%, and 5.2%, respectively. Multivariate logistic regression analysis found age (OR 0798, 95%CI: 0.769-0.829; P<0.001), STS risk grade (OR 1.267, 95%CI: 1.159-1.385; P<0.001), body mass index (BMI) <5th percentile (OR 1.295, 95%CI: 1.023-1.639; P=0.032), BMI ＞95th percentile (OR 0.792, 95%CI: 0.647-0.969; P=0.023), cardiopulmonary bypass (CPB) time (OR 1.008, 95%CI: 1.003-1.012; P<0.001) and aortic clamping time （OR 1.009, 1.002-1.015; P = 0.008）were significantly associated with nosocomial infection in CHD infants. After adjusted for confounding factors, we found STS risk grade (OR 1.38, 95%CI: 1.167-1.633; P<0.001), BMI<5th percentile (OR 1.934, 95%CI: 1.377-2.715; P<0.001), CPB time (OR 1.018, 95%CI: 1.015-1.022; P<0.001), lymphocyte/WBC ratio﹤cut off value (OR 3.818, 95%CI: 1.529-9.533; P=0.004) and AST＞cut off value (OR 1.546, 95%CI: 1.119-2.136; P=0.008) were significantly associated with nosocomial infection in CHD children. Conclusion: Our study suggested STS risk grade, BMI, CPB duration, low lymphocyte/WBC or high neutrophil/WBC ratio were independently associated with nosocomial infection in CHD infant and children after cardiac surgery.

scholarly journals Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

2019 ◽  
Author(s):  
Xindi Yu ◽  
Maolin Chen ◽  
Xu Liu ◽  
Yiwei Chen ◽  
Zedong Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infection ◽  
Congenital Heart ◽  
Medical Center ◽  
Multivariate Logistic Regression Analysis ◽  
Baseline Characteristics ◽  
Risk Grade

Abstract Background: The aim of our study was to analyze the risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease (CHD). Methods: We performed a retrospective cohort study, and children with CHD who underwent open-heart surgeries at Shanghai Children’s Medical Center from January 1, 2012 to December 31, 2018 were included. The baseline characteristics of these patients of different ages, including neonates (0-1 months old), infants (1-12 months old) and children (1-10 years old), were analyzed, and the association of risk factors with postoperative nosocomial infection were assessed. Results: A total of 11651 subjects were included in the study. The overall nosocomial infection rate was 10.8%. Nosocomial infection rates in neonates, infants, and children with congenital heart disease were 32.9%, 15.4%, and 5.2%, respectively. Multivariate logistic regression analysis found age (OR 0798, 95%CI: 0.769-0.829; P<0.001), STS risk grade (OR 1.267, 95%CI: 1.159-1.385; P<0.001), body mass index (BMI) <5th percentile (OR 1.295, 95%CI: 1.023-1.639; P=0.032), BMI ＞95th percentile (OR 0.792, 95%CI: 0.647-0.969; P=0.023), cardiopulmonary bypass (CPB) time (OR 1.008, 95%CI: 1.003-1.012; P<0.001) and aortic clamping time （OR 1.009, 1.002-1.015; P = 0.008）were significantly associated with nosocomial infection in CHD infants. After adjusted for confounding factors, we found STS risk grade (OR 1.38, 95%CI: 1.167-1.633; P<0.001), BMI<5th percentile (OR 1.934, 95%CI: 1.377-2.715; P<0.001), CPB time (OR 1.018, 95%CI: 1.015-1.022; P<0.001), lymphocyte/WBC ratio﹤cut off value (OR 3.818, 95%CI: 1.529-9.533; P=0.004) and AST＞cut off value (OR 1.546, 95%CI: 1.119-2.136; P=0.008) were significantly associated with nosocomial infection in CHD children. Conclusion: Our study suggested STS risk grade, BMI, CPB duration, low lymphocyte/WBC or high neutrophil/WBC ratio were independently associated with nosocomial infection in CHD infant and children after cardiac surgery.

scholarly journals Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xindi Yu ◽  
Maolin Chen ◽  
Xu Liu ◽  
Yiwei Chen ◽  
Zedong Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infection ◽  
Congenital Heart

Nineteen Years of Adult Congenital Heart Surgery in a Single Center

2017 ◽  
Vol 8 (2) ◽  
pp. 182-188
Author(s):  
Madurra Perinpanayagam ◽  
Signe H. Larsen ◽  
Kristian Emmertsen ◽  
Marianne B. Møller ◽  
Vibeke E. Hjortdal
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Congenital Heart ◽  
Postoperative Bleeding ◽  
Registration System ◽  
Growing Population

Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

scholarly journals The diagnostic value of combined indexes in Acute Renal injury after Cardiopulmonary Bypass Surgery in infants with Congenital Heart Disease

2020 ◽  
Author(s):  
Haifei Yu ◽  
Xinrui Wang ◽  
Qiang Chen ◽  
Liangpu Xu ◽  
Hua Cao
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Congenital Heart ◽  
Hepatic Function ◽  
Blood Oxygen ◽  
Acute Renal Injury ◽  
Blood Oxygen Saturation

Abstract Objective: To investigate the incidence and risk factors of acute renal injury (AKI) after cardiopulmonary bypass (CPB) cardiac surgery in infants with congenital heart disease(CHD). Methods: Single-center data from a total of 613 infants with congenital heart disease who underwent cardiothoracic surgery in Fujian Union Hospital.The included patients were divided into two groups according to the occurrence of AKI: AKI group (n = 68) and non-AKI group (n = 92). We obtained clinical data from the electronic hospitalization information system and the laboratory database. All infants were tested for serum creatinine at least twice within 12 hours of admission and after operation. We determined AKI events according to creatinine criteria for improving global prognosis of renal diseases.The general and clinical data of the infants were collected, and the related risk factors were explored by univariate analysis and Logistic regression analysis. Results: 160 patients had congruent lab and echocardiogram data foranalysis. Most of patients are male (56.26%). Original congenital cardiac malformation is similar with our study, the most common is left-to-right shunt CHD(58%), followed by right-to-left shunt CHD(18.75%). All patients showed differences in liver function, renal function, cardiac function and inflammatory indexes within 12 hours of admission and after operation(p<0.05). The AKI group and non-AKI group showed Significant statistical difference in arein age, serum myocardial enzyme , hepatic function, ejection fraction , hemoglobin , platelet count were significantly different meaning (p<0.05). Regression analyses showed that blood oxygen saturation (95%CI 1.003-2.999), CREA(95%CI 1.070-1.253), UREA(95%CI 1.180-3.325), CRP(95%CI 1.006-1.058), BNP(95%CI 0.999-1.000) at 12 hours postoperatively, and in admission to PCT (95%CI 0.461-0.936), Neu(95%CI 0.909-0.995), ALP(95%CI 1.070-1.253) , nadir intraoperative renal regional tissue oximetry to be independent predictors of postoperative kidney damage as measured by blood oxygen saturation, hepatic function, kidney function, cardiac function , Serum myocardial enzyme , inflammatory factor s and blood Routine . Conclusions: Choosing the best age for infants's cardiac surgery, actively preventing preoperative complica- tions, postoperative pneumonia, heart failure and hypoxia play an important role in preventing AKI.

Prolonged Candidemia in Infants Following Surgery for Congenital Heart Disease

2003 ◽  
Vol 24 (10) ◽  
pp. 753-757 ◽  
Author(s):  
Chandrama Chakrabarti ◽  
Sunil K. Sood ◽  
Vincent Parnell ◽  
Lorry G. Rubin
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Case Control Study ◽  
Case Control ◽  
Complex Congenital Heart Disease ◽  
Common Source ◽  
Control Study

AbstractObjectives:To describe a group of infants with complex congenital heart disease (CCHD) who had candidemia postoperatively and to perform a case–control study of risk factors.Design:Descriptive and case–control study.Setting:Tertiary-care medical centers.Patients:Infants with CCHD who underwent cardiac surgery and developed candidemia. Controls were matched for congenital heart disease lesions, age, and postoperative hospital stay.Results:Of 95 infants younger than 6 months with CCHD who underwent cardiac surgery between January 1999 and April 2001, 6 (6.3%) developed candidemia with 5 different species. The candidemia was prolonged (range, 12 to 32 days; median, 17 days). The interval between cardiac surgery and onset of candidemia was 12 to 57 days (median, 24 days). All had a central venous catheter inserted 8 to 50 days prior to the onset of candidemia. The mortality rate was 83%, compared with 13% for the group without candidemia. A univariate analysis of the potential risk factors revealed that duration of total parenteral nutrition (TPN), duration of antibiotics, intraoperative cardiopulmonary bypass time, and documentation of an intravascular thrombus were associated with candidemia. In multivariate analysis, long duration of TPN and documentation of a thrombus were associated with candidemia.Conclusions:Candidemia following cardiac surgery for infants with CCHD was persistent and associated with high mortality. The variety of species indicates that this was not a common-source outbreak. Risk factors associated with candidemia were duration of TPN and documentation of an intravascular thrombus.

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