scholarly journals Frequency and Risk Factors of Purulent Septic Infection among Adults after Different Types of an Open Heart Operations

2020 ◽  
Vol 19 (5) ◽  
pp. 34-40
Author(s):  
V. I. Sergevnin ◽  
L. G. Kudryavtseva ◽  
A. I. Zolotukhina
Keyword(s):  
Risk Factors ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Aortic Surgery ◽  
Open Heart Surgery ◽  
Incidence Rates ◽  
Open Heart ◽  
Hospital Acquired Pneumonia ◽  
Definition Of ◽  
Hospital Acquired

Relevance. The problem of purulent postoperative septic infection (the hospital acquired infection or HAI) is still one of the main cause of fatal outcomes of patients in cardiac hospitals, which demands significant material costs. The aim of the work is to evaluate the intensity of the epidemic process and risk factors for HAI among adults after various types of open heart surgery.Materials and methods. The study of medical records of 1540 patients over 18 years old, who underwent open heart surgery for the purpose of coronary artery bypass grafting (CABG), prosthetics of valves and elimination of aortic defects, was held. Typical and donozological forms of HAI were taken into account in accordance with the epidemiological standard definition of cases.Results. The incidence rates of typical and donozological forms of HAI in average was 39.6 and 72.7 per 1000 operations. The maximum incidence of HAI was detected after aortic surgery due to urinary tract infection (UTI) and hospital-acquired pneumonia.Conclusions. It was found that the increased incidence of UTI and hospital-acquired pneumonia after aortic surgery is contingent on a longer cardiosurgical operations and, accordingly, a longer stay of patients in the Department of anesthesia and resuscitation, accompanied by artificial ventilation and catheterization of the bladder, than in other cardiac operations

scholarly journals Comparative assessment of the frequency and risk factors of purulent-septic infections in adult patients after various types of open and closed heart surgery

2020 ◽  
Vol 25 (2) ◽  
pp. 78-87
Author(s):  
Victor I. Sergevnin ◽  
Larisa G. Kudryavtseva
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Incidence Rates ◽  
Comparative Assessment ◽  
Open Heart ◽  
Patient Stay ◽  
Subsequent Patient

BACKGROUND: The widespread increase in the number and types of cardiac surgery necessitate the study of frequency and risk factors of postoperative purulent-septic infections (PSIs). AIM: to provide a comparative assessment of the PSI frequency and risk factors in adult patients after various types of cardiac surgery. MATERIALS AND METHODS: Based on the cardiac surgery hospital materials, medical records of 4.815 patients over 18 years of age, who underwent open (n = 1.540) and closed (n = 3.275) heart surgeries within 1 year, were analyzed. The typical and prenosological forms of PSIs were taken into account in accordance with the epidemiological standard of case definition. RESULTS: The incidence rates for typical and prenosological PSI forms amounted to 39.6 and 72.7 per 1000 surgeries after open heart surgery, respectively, and 3.1 and 3.9 after minimally invasive endovascular surgical interventions, respectively. The main clinical forms of PSI after open and closed heart surgeries were surgical site infections, nosocomial pneumonia, urinary tract infection, and bloodstream infection. In an open heart surgery, the maximum incidence rates for typical and prenosological forms of PSIs were recorded after surgeries on the aorta and less often after heart valve replacement or coronary artery bypass grafting. The increased incidence rate after aortic surgery was mainly due to urinary tract infection and nosocomial pneumonia. In the case of closed heart surgery, no statistically significant differences were detected between the incidence rates of PSIs after coronary artery stenting, cardiac arrhythmia and carotid artery stenosis surgery, and other interventions. The duration of both the surgery itself and the subsequent patient stay in the intensive care unit was found to be important as risk factors for PSIs after cardiac surgery. CONCLUSION: The incidence rate of PSIs after open heart surgery is significantly higher than after closed heart surgery, which is mostly associated with the duration of surgical intervention and the subsequent patient stay in the intensive care unit.

scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2019 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 23%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2020 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 21%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals Clinical and histological predictive risk factors of atrial fibrillation in patients undergoing open-heart surgery

2015 ◽  
Vol 10 (6) ◽  
pp. 2299-2304 ◽  
Author(s):  
GRIGORE TINICA ◽  
VERONICA MOCANU ◽  
FLORIN ZUGUN-ELOAE ◽  
DOINA BUTCOVAN
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Predictive Risk

scholarly journals Risk Factors for Candidemia After Open Heart Surgery: Results From a Multicenter Case–Control Study

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Daniele Roberto Giacobbe ◽  
Antonio Salsano ◽  
Filippo Del Puente ◽  
Ambra Miette ◽  
Antonio Vena ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Heart Surgery ◽  
Case Control Study ◽  
Open Heart Surgery ◽  
Case Control ◽  
Open Heart ◽  
Previous Therapy ◽  
Control Study

Abstract Background Candida species are among the most frequent causative agents of health care–associated bloodstream infections, with mortality &gt;40% in critically ill patients. Specific populations of critically ill patients may present peculiar risk factors related to their reason for intensive care unit admission. The primary objective of the present study was to assess the predictors of candidemia after open heart surgery. Methods This retrospective, matched case–control study was conducted in 8 Italian hospitals from 2009 to 2016. The primary study objective was to assess factors associated with the development of candidemia after open heart surgery. Results Overall, 222 patients (74 cases and 148 controls) were included in the study. Candidemia developed at a median time (interquartile range) of 23 (14–36) days after surgery. In multivariable analysis, independent predictors of candidemia were New York Heart Association class III or IV (odds ratio [OR], 23.81; 95% CI, 5.73–98.95; P &lt; .001), previous therapy with carbapenems (OR, 8.87; 95% CI, 2.57–30.67; P = .001), and previous therapy with fluoroquinolones (OR, 5.73; 95% CI, 1.61–20.41; P = .007). Crude 30-day mortality of candidemia was 53% (39/74). Septic shock was independently associated with mortality in the multivariable model (OR, 5.64; 95% CI, 1.91–16.63; P = .002). No association between prolonged cardiopulmonary bypass time and candidemia was observed in this study. Conclusions Previous broad-spectrum antibiotic therapy and high NYHA class were independent predictors of candidemia in cardiac surgery patients with prolonged postoperative intensive care unit stay.

Mediastinitis in open heart surgery: a systematic review and meta-analysis of risk factors

2019 ◽  
Vol 53 (5) ◽  
pp. 226-234
Author(s):  
Michael Abdelnoor ◽  
Irene Sandven ◽  
Øystein Vengen ◽  
Ivar Risnes
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Heart Surgery ◽  
Meta Analysis ◽  
Open Heart Surgery ◽  
Open Heart

scholarly journals A.14 Low cardiac output syndrome after open-heart surgery: intraoperative risk factors

1996 ◽  
Vol 76 ◽  
pp. 4-5
Author(s):  
S. Garrido ◽  
M.J. Martín ◽  
S. Rodiño ◽  
J. Llorens ◽  
C.R. Valdés ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Output ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output
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