TITLE:
Incidence and Outcomes of Surgical Site Infections after Adult Cardiac Surgery: A Single-Center Experience
AUTHORS:
Ibraheem H. Alharbi, Hasan I. Sandogji, Ahmed M. Shabaan, Khaled M. Sayed, Bilal A. Rahmani, Mohamed A. Elmetwali, Nouf A. Lami, Thikra S. Alkhalaf, Shyelene T. Utuanis, Ayman R. Abdelrehim
KEYWORDS:
Surgical Site Infection, Cardiac Surgery, Mortality, Risk Factors, Outcomes
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.11,
November
21,
2023
ABSTRACT: Background: Surgical site infections (SSIs) remain a challenging medical problem,
especially in cardiac surgery patients. There is a lack of studies evaluating
the rate of and outcomes of SSIs following cardiac surgeries in Saudi Arabia. Aims: This study aimed to determine the incidence of SSIs after adult cardiac
surgeries that were done in Madinah Cardiac Center, Saudi Arabia. Further, to identify the outcomes and risk factors
contributing to death among surgical site infection patients. Methods: This was a 6-year, single-center, retrospective cohort study that included
93 consecutive patients who underwent adult cardiac surgery between August 2016
and August 2022. All adult patients aged 18 years or older who had clinical
evidence of postoperative surgical wound infection were included. Preoperative,
operative, and postoperative data (early and late) were collected from medical
records. Microbiological culture reports and clinical outcomes were also
recorded. Results: The study revealed a 9.1% (93/1021) incidence rate of
SSIs. Of the 93 patients with SSIs, 60 had superficial incisional infections
and 33 had deep infections with incidence rates of 5.9% and 3.2%, respectively.
In-hospital mortality due to SSI was recorded in 4 out of 93 patients with an
incidence rate of 4.3%. There was a significant association between the
in-hospital mortality and the type of SSIs (p = 0.014). All non-survivors had
deep SSIs. The type of cardiac surgery also showed a significant association
with the in-hospital mortality (p = 0.017). Furthermore, the median duration of
antibiotic administration was significantly longer in the non-survivors than in
the survivors (72.5 vs 17, respectively, p Conclusions: In
conclusion, the incidence of surgical wound infections following cardiac
surgery is not low (9.1%); of which 3.2% were deep infections. The in-hospital
mortality rate after treatment of SSIs was fortunately low (4.3%), and all
non-survivors had deep SSIs. The non- survivors
showed a significantly longer duration of antibiotics administration than survivors. Combined CABG and valve procedures
showed a higher mortality rate (75%) than the isolated procedures.