Abstract
Background and aims: Nosocomial infections are a common complication after cardiac surgery in children. Identifying patients at risk for this complication is essential to minimize postoperative morbidity and mortality. This study describes the incidence and characteristics of nosocomial infections after pediatric cardiac surgery at our institution. Furthermore, predictors for these infections are evaluated for their prognostic value.
Methods: A retrospective cohort study was performed including all pediatric patients who underwent cardiac surgery with use of cardiopulmonary bypass from April 2006 until May 2009. Nosocomial infections were defined using Center of Disease Control-criteria. Clinically available variables, known at 48 hours postoperatively, were included in a univariate analysis to evaluate their association with nosocomial infections. A multivariable analysis was performed to identify independent risk factors and the prognostic value of the model was assessed.
Results: Following 416 procedures, nosocomial infections occurred in 102 patients (24.7%). Four independent risk factors were identified by multivariable analysis: lower weight, open sternum postoperatively, presence of a noncardiac comorbidity and postoperative stay at the intensive care >48 hours. A prognostic model combining these factors yielded a predictive value of 78.2%.
Conclusions: At 48 hours after pediatric cardiac surgery, four independent variables predict the occurrence of an infection: lower weight, presence of a noncardiac comorbidity, open sternum postoperatively and current admission at the intensive care. However, when combined in a model, the prognostic value of these predictors is poor. Consequently, early recognition of patients at high risk for infection remains difficult.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Algra, S., Driessen, M., Schadenberg, A. et al. 520 Prediction of Nosocomial Infections After Pediatric Cardiac Surgery. Pediatr Res 68 (Suppl 1), 266 (2010). https://doi.org/10.1203/00006450-201011001-00520
Issue Date:
DOI: https://doi.org/10.1203/00006450-201011001-00520