Infección del sitio quirúrgico en niños sometidos a cirugía cardíaca con cierre esternal diferido: estudio de casos y controles / Surgical site infections in children undergoing cardiac surgery with delayed sternal closure: case-control study
Rev. chil. infectol
; 33(5): 495-500, oct. 2016. ilus, tab
Article
in Spanish
| LILACS
| ID: biblio-844398
Responsible library:
CL1.1
ABSTRACT
Introduction:
Surgical site infections (SSI) are an important cause of morbidity in pediatric cardiac surgery. Risk factors in patients requiring delayed sternal closure (DSC) are unknown.Aim:
To report the rate of SSI in children undergoing cardiac surgery with DSC and determine the risk factors.Methodology:
A retrospective case-control study, in patients younger than 15 years old undergoing cardiac surgery with DSC in our center between 2009 and 2010. SSI was diagnosed according to the criteria of the nosocomial infections committee of our institution, based on international recommendations. Univariate and multivariate analysis of variables was performed. A p < 0.05 was considered significant.Results:
58 patients were included; the average age was 9.5 days. The most frequent diagnosis were transposition of the great arteries (36%) and hypoplastic left heart syndrome (27%). 13 patients had SSI (22%); 11 incisional and 2 mediastinitis. It was independently associated to SSI by-pass (BP) time longer than 200 min (OR adjusted = 9,53; IC 95% 1,37-66,35) and mechanical ventilation (MV) more than 5 days (OR adjusted = 8,98; IC 95% 1,16-69,40).Conclusion:
The duration of BP and MV are risk factors of SSI in children undergoing cardiac surgery with DSC.RESUMEN
Introducción:
Las infecciones del sitio quirúrgico (ISQ) son importante causa de morbilidad en cirugía cardíaca pediátrica. Los factores de riesgo en pacientes que requieren cierre esternal diferido (CED) se desconocen.Objetivos:
Reportar la tasa de ISQ en niños sometidos a cirugía cardíaca con CED y determinar factores de riesgo de ISQ.Metodología:
Estudio retrospectivo de casos y controles en pacientes bajo 15 años de edad, sometidos a cirugía cardíaca con CED, en los años 2009 y 2010. Se consideró casos aquellos con ISQ diagnosticada según criterios del comité de IAAS local. Se realizó análisis uni y multivariado de las variables. Se consideró significativo un p < 0,05.Resultados:
Se incluyeron 58 pacientes; la mediana de edad fue 9,5 días. Diagnósticos más frecuentes fueron transposición de grandes arterias (36%) e hipoplasia de ventrículo izquierdo (27%). Trece pacientes presentaron ISQ (22%); 11 incisionales y 2 me-diastinitis. Se asociaron de manera independiente a ISQ circulación extracorpórea (CEC) mayor a 200 min (OR ajustado = 9,53; IC 95% 1,37-66,35) y ventilación mecánica invasora (VMI) más de 5 días (OR ajustado = 8,98; IC 95% 1,16-69,40).Conclusión:
La duración de CEC y VMI son factores de riesgo de ISQ en niños sometidos a cirugía cardíaca con CED.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
Health problem:
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
LILACS
Main subject:
Surgical Wound Infection
/
Sternotomy
/
Heart Defects, Congenital
/
Cardiac Surgical Procedures
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Risk factors
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Infant, Newborn
Language:
Spanish
Journal:
Rev. chil. infectol
Journal subject:
Communicable Diseases
Year:
2016
Document type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Pontificia Universidad Católica de Chile/CL