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Volume 43, Number 5, October 2010

Outcome and Risk Factors Associated with Surgical Site Infections
After Cardiac Surgery in a Taiwan Medical Center

Yu-Pei Lee, Ming-Chu Feng, Ling-Chu Wu, Shu-Hui Chen, Yen-Hsu Chen, Chaw-Chi Chiu, Tun-Chieh Chen, Po-Liang Lu

Received: June 1, 2009    Revised: July 16, 2009    Accepted: August 17, 2009   


Corresponding author:

Po-Liang Lu, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung City, Taiwan.



Background and purpose: 

Surgical site infection (SSI) after cardiac surgery leads to morbidity and mortality. Identifying SSI risk factors, which vary between populations, is important in preventing infection.



A retrospective chart review of adult cases receiving cardiac surgery in a Taiwan medical center in 2004 and 2005



Of the 260 cases included in the study, 169 (65.0%) received a coronary artery bypass graft, 65 (25.0%) cardiac valvular surgery and 26 (10.0%) aortic or septal defect operations. The SSI rate was 13.5%. Univariate analysis showed that chronic obstructive pulmonary disease (COPD) (p = 0.008), congestive
heart failure New York Heart Association class IV (p = 0.048), longer preoperative hospital stay,  reoperative nosocomial infection, higher volume of blood loss and larger packed red blood cell transfusions during the operation were significantly related to SSI. Logistic regression analysis further identified COPD, preoperative nosocomial infection and emergency surgery as being independently associated with SSI (odds ratios of 4.96, 5.88 and 9.77, respectively). Obesity and diabetes mellitus were not associated with SSI.



COPD is an independent underlying illness associated with SSI after cardiac surgery. Minimizing preoperative hospitalization and nosocomial infection, and awareness of cases presenting with relevant risk factors, are useful in reducing SSI.


Key words:

cardiac surgery, outcome, risk factors, surgical site infection