ABSTRACT
Background: hepatitis B and C are becoming a common occurrence in patients who are admitted for major surgical procedures and associated with significant morbidity and mortality. We evaluated the prevalence of hepatitis B and C admitted for different procedures in the cardiac surgery ward in relation to their postoperative recovery
Patients and Methods: one hundred and twenty six patients admitted during July to December 2007, 23.8% [n=30] were found to be seropositive. Data of 23 patients were available 65.2% [n=15] were male. The mean age of the subjects was 41 years, 56.5% [n=13] were seropositive for hepatitis B whereas 43.5% [n=10] for hepatitis C., 26% [n=6] had deranged preoperative LFT's. Post operatively 6 patients [26.1%] developed abnormal LFTs. Poor left ventricular function was present in 2[8.7%] patients, hypertension was present in 17.4%[n=4], 1 patient[4.3%] was Diabetic and obese, 2 patients[8.6%] have creatinine level more than 2 mg/dl
Results: the overall mortality was only 8.7% [n=2]. Altogether 60.9% [n=14] patients developed morbidities that comprised of: arrhythmias 13%[n=3], re-exploration 30.4%[n=7], wound dehiscence 4.3%[n=1] and in 10 cases [43.5%], morbidities other than these were seen that included: cardiac tamponade, disorientation, cough with hematemesis, infective endocarditis, renal failure, raised BP, delayed chest wound healing with persistent fever, bone pain and failure of saphenous graft. The mean time for bypass; 87 min and time for x-clamp; 58 min, 52% [n=12] patients needed inotropic support postoperatively with mean duration of 15 hrs. mean extubating time was 9.3 hrs. whereas mean time for removal of drain was 30.28 hrs. Bleeding recorded at 6hrs was 515 ml, at 24hrs; 903 ml and 422 ml on 2nd POD. The mean duration for ICU stay came out to be 3 days and ward stay was 4 days
Conclusions: * Approximately ¼ of the patients admitted during the 6 months period came out to be seropositive for hepatitis B and hepatitis C. * The number of affected males was greater than females. * Incidence of hepatitis B was greater than hepatitis C. * Practice of getting shave or hair cut from street barbers and needle prick injuries were popular source of infections particularly for hepatitis B virus, whereas blood transfusion and previous surgery got more response among hepatitis C seropositive. * Morbidity and mortality were high among these patients * Awareness regarding the above among general population and doctors should be created via public mass education