Investigation of Incidence and Risk Factors of Surgical Site Infections After Cardiothoracic Surgery

Objective: The aim of this study is to investigate the incidence and risk factors of surgical site infections (SSIs) after cardiothoracic surgery. Methods: Patients who had cardiothoracic surgery at Gazi University Faculty of Medicine between June 2011 and May 2012 were included in the study. Surveillance was active, prospective, patient- and laboratory-based. The diagnosis of postoperative SSI was made according to the criteria of the Centers for Diseases Control and Prevention and Department of National Surveillance and Control of Hospital Infections. The rate of SSIs was calculated by using the following formula: number of SSIs/number of surgeriesx100.The incidence density was calculated by using the following formula: number of SSIs/patient daysx1000. Risk categories for each operation were determined. These categories were calculated according to the risk index by National Nosocomial Infection Surveillance (NNIS). Results: A total of 238 consecutive patients were enrolled in the study. SSI was detected in 22 patients and postoperative SSI incidence density was 7.04 per 1000 admission days. Six of 22 SSIs were superficial primer incisional (27%), 11 were deep primer incisional (50%), and 5 were organ/space SSIs (23%). High American Society of Anesthesiologists (ASA) score was identified as a significant risk factor for all SSIs. Prolongation of hospital stay has been shown to increase SSI development for patients older than 65. There was a weak positive correlation between NNIS system risk index and SSI development. Diabetes mellitus was found to be a significant risk factor for superficial SSI. Malignancy was found to be a significant risk factor for organ/space infections. Mortality rate was found to be 9.7%. There was no significant correlation between SSI development and mortality. Conclusions: SSI surveillance is a priority as a part of infection control. Identification of risk factors and monitoring of the effectiveness of infection control policies are necessary for management of SSI.