Hong Kong Med J 2008;14:371-8 | Number 5, October 2008
An audit of risk factors for wound infection in patients undergoing coronary artery bypass grafting or valve replacement
Wendy F Bower, Catherine SK Cheung, Raymond WM Lai, Malcolm J Underwood, C Andrew van Hasselt
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
OBJECTIVES. To investigate the epidemiology of surgical site infection in cardiac surgery patients operated on in 2006.
DESIGN. Retrospective study of a case-control sample.
SETTING. Cardiac surgery unit of a university teaching hospital in Hong Kong.
PATIENTS. Cardiac surgery patients with surgical site infection were matched by procedure type, sex, and year of surgery with non-infected patients.
MAIN OUTCOME MEASURES. Identification of risk factors for surgical site infection.
RESULTS. The infected and non-infected cardiac surgery patients did not differ in age, sex, or smoking history; however, patients with surgical site infection were significantly heavier (mean body mass index, 26.6 vs 23.9 kg/m2), P<0.046). Almost 41% of the subjects had a history of diabetes mellitus, there being a significantly greater proportion among infected than non-infected patients (53.1% vs 28.1%, P<0.042). All 37 of the patients without a diagnosis of diabetes had normal (ie <8 mmol/L) preoperative glucose levels, but 99% of them yielded evidence of subsequent glycaemic dysfunction during or after surgery. Overall, 50% of the patients had a blood transfusion during the operation, with infected patients significantly more likely to have been transfused than the non-infected ones (65.6% vs 34.4%, P<0.008).
CONCLUSIONS. There appears to be a relationship between surgical site infection in cardiac surgery patients and pre-existing (diagnosed and covert) diabetes mellitus and blood transfusion. Future studies should consider these factors in relation to surgical site infections, both in the wider surgical population and from a risk-minimisation perspective.
Key words: Blood transfusion; Cardiac surgical procedures; Diabetes mellitus; Risk factors; Surgical wound infection
View this abstract indexed in MEDLINE: