HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miholic, J. Articles by Wolner, E. Search for Related Content PubMed PubMed Citation Articles by Miholic, J. Articles by Wolner, E.

The Annals of Thoracic Surgery, Vol 40, 224-228, Copyright © 1985 by The Society of Thoracic Surgeons

ARTICLES

Risk factors for severe bacterial infections after valve replacement and aortocoronary bypass operations: analysis of 246 cases by logistic regression

J Miholic, M Hudec, E Domanig, H Hiertz, W Klepetko, F Lackner and E Wolner

Risk factors for severe bacterial infections, that is, deep sternal wound infection, pneumonia, septicemia, and prosthetic valve endocarditis, were evaluated in 246 consecutive patients undergoing valve replacement (N = 84) or aortocoronary bypass operation (N = 162). Multiple logistic regression analysis was applied to determine the ability of putative risk factors to predict infection. The risk factors considered were age, sex, diabetes mellitus, duration of cardiopulmonary bypass (CPB), duration of operation, amount of blood restored on the day of operation, repeat thoracotomy for bleeding, intraaortic balloon pumping, reoperation, emergency operation, and the professional status of the surgeon. Severe infections occurred in similar frequency after valve replacement (8/84; 9.5%) and aortocoronary bypass (11/162; 6.8%). For patients who had a bypass procedure, repeat thoracotomy was the only factor significantly associated with infection (p = 0.0004). However, the classification analysis revealed that this variable alone is too unspecific for a reliable prediction. Univariate analysis indicated that restoration of more than 2,500 ml of blood (p = 0.0001), reoperation (p = 0.0821), duration of operation (p = 0.0061), duration of CPB (p = 0.0318), and intraaortic balloon pumping (p = 0.0281) were associated with infection following valve replacement. A model with three variables emerged from the multiple logistic regression: after correction for blood restoration, reoperation, and duration of CPB, no other variable was of additional predictive value. For patients who underwent valve replacement, the model performed well in predicting complications. The classification analysis revealed a high correspondence between observed and predicted instances of infection: it correctly predicted 75% of the patients with infection and 96% of those without infection.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				C. P. Charalambous, C. S. Zipitis, and D. J. Keenan Chest Reexploration in the Intensive Care Unit After Cardiac Surgery: A Safe Alternative to Returning to the Operating Theater Ann. Thorac. Surg., January 1, 2006; 81(1): 191 - 194. [Abstract] [Full Text] [PDF]

				Z. A. Ali, E. Lim, R. Motalleb-Zadeh, A. A. Ali, C. J. Callaghan, C. Gerrard, A. Vuylsteke, J. Foweraker, and S. Tsui Allogenic Blood Transfusion Does Not Predispose to Infection After Cardiac Surgery Ann. Thorac. Surg., November 1, 2004; 78(5): 1542 - 1546. [Abstract] [Full Text] [PDF]

				S. R. Leal-Noval, M. D. Rincon-Ferrari, A. Garcia-Curiel, A. Herruzo-Aviles, P. Camacho-Larana, J. Garnacho-Montero, and R. Amaya-Villar Transfusion of Blood Components and Postoperative Infection in Patients Undergoing Cardiac Surgery Chest, May 1, 2001; 119(5): 1461 - 1468. [Abstract] [Full Text] [PDF]

				C. Kuhn, U. Muller-Werdan, D.V. Schmitt, H. Lange, G. Pilz, E. Kreuzer, F.W. Mohr, H.-R. Zerkowski, and K. Werdan Improved outcome of APACHE II score-defined escalating systemic inflammatory response syndrome in patients post cardiac surgery in 1996 compared to 1988-1990: the ESSICS-study pilot project Eur. J. Cardiothorac. Surg., January 1, 2000; 17(1): 30 - 37. [Abstract] [Full Text] [PDF]

				E. J. Fransen, J. G. Maessen, T. W.O. Elenbaas, E. E.H.L. van Aarnhem, and M. P. van Dieijen-Visser Increased preoperative C-reactive protein plasma levels as a risk factor for postoperative infections Ann. Thorac. Surg., January 1, 1999; 67(1): 134 - 138. [Abstract] [Full Text] [PDF]

				C. Y. Bitkover and B. Gardlund Mediastinitis After Cardiovascular Operations: A Case-Control Study of Risk Factors Ann. Thorac. Surg., January 1, 1998; 65(1): 36 - 40. [Abstract] [Full Text] [PDF]

				M. H. Rebollo, J. M. Bernal, J. Llorca, J. M. Rabasa, and J. M. Revuelta NOSOCOMIAL INFECTIONS IN PATIENTS HAVING CARDIOVASCULAR OPERATIONS: A MULTIVARIATE ANALYSIS OF RISK FACTORS J. Thorac. Cardiovasc. Surg., October 1, 1996; 112(4): 908 - 913. [Abstract] [Full Text]