| Background:Surgical site infection (SSI) is a commonly-occurring healthcare-associated infection, complicating 2-5% of surgeries in the United States. In parts of chest surgery in our country the incidence of surgical site infection was 5.87%. And a wider range of research shows that the incidence of surgical site infection after heart surgery is 0.6%-6.6%, but the investigation and analysis of Liang Weitao that sternum midline incision infection rate was 1.4%, li Ming’s results for cardiac surgery surgical site infection incidence of 2.87%, is different from other reports. Increased morbidity and mortality are associated with SSI, ranging from wound discharge associated with superficial skin infection to life-threatening conditions such as severe sepsis. The risk of developing an SSI is multifactorial. In observational studies, a wider breadth of risk factors and their impact on incidence of SSI can be observed based on routine clinical practice, and for a larger range of patients, as opposed to the narrow focus on particular risk factors that may be considered within clinical trials. SSI as a continuing challenge and a hated burden for the health care system, we need to have more accurate and specific judgment on its mechanism and promoting factors, and a accurate evaluation of the effectiveness of the current preventive measures.Objective:To more accurate and comprehensive evaluate the current prevention and treatment measures? the possible mechanism in detail and the SSI associated risk factors with open-heart operation, and then we can provide more accurate and reliable scientific basis for the better understanding of SSI, improve the prevention and treatment in clinical practices; also we can explore the feasibility of prediction model of postoperative surgical site infection in cardiac surgery patients.Methods:All 1384 cases of open heart surgery done at the Department of Cardiovascular Surgery in a grade A tertiary hospital from January 2011 to October 2014 were retrospectively analyzed, and out of which there were 51 cases with SSI. The other contemporaneous patients without SSI were selected by 1:2 ratio, and the risk factors include gender, sex, body mass index, smoking, diabetes, operation time, etc, then multivariate logistic regression was used to determine the independent association of patient and surgical covariates with risk of any SSI. Data were analyzed by SPSS 22.0.Results:There were 51 patients with SSI among 1384 patients after open heart surgery, and the incidence of SSI was 3.68%, including superficial infection(84.31 %, 43), deep(13.73 %,7), organ space(1.96 %,1). Multivariate logistic regression analysis showed that duration of operation(> 2.5 h), ICU stay(> 2 d), postoperative fever(> 3d,> 38.5℃) were the independent risk factors associated with SSI(P< 0.05).Conclusions:Strict aseptic technique, short operation time and improvement of postoperative management in ICU can reduce the incidence of SSI. Longer postoperative ICU stay and postoperative fever may become the predictive and diagnostic indicators of SSI. We can establish a prediction model of postoperative surgical site infection based on the characteristics of cardiac surgery. |
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