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Influence of Perioperative Variables on Surgical Site Infection in Patients With Frailty and Prefrailty Undergoing Coronary Artery Bypass Grafting: Retrospective Multicenter Study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Guerrieri Mauricio, Mejia Omar, Meneghini Bianca, Rodrigues Natali, Burato William, Barros Maisa, Wernsbach Daniel, Bartelega Lucas, Hueb Alexandre, Jatene Fabio
Аннотация
BACKGROUND: Surgical site infection (SSI) in patients with frailty undergoing myocardial revascularization is a major clinical challenge, and there is a gap in the literature related to this topic.
OBJECTIVE: This study aimed to identify perioperative variables associated with SSI in patients with frailty and prefrailty undergoing coronary artery bypass grafting within 30 days of the procedure.
METHODS: This retrospective observational study included 467 patients with frailty or prefrailty aged 60 years and older who underwent coronary artery bypass grafting in 6 Brazilian centers between January 2018 and December 2024. Frailty was defined using the Fried criteria. SSI was defined as a wound with exposed tissue with positive culture requiring antibiotic treatment. Univariate and multivariate analyses were carried out.
RESULTS: The rate of SSI was 5.6% (26/467). The New York Heart Association classification (P=.02), Charlson Comorbidity Index (CCI; P=.01), use of cardiopulmonary bypass (CPB; P=.003), CPB time (P=.02), total surgery time (P<.001), occurrence of bleeding (P=.04), mechanical ventilation time (P=.001), length of hospital stay (P<.001), intensive care unit stay (P<.001), and need for reoperation (P<.001) variables were associated with SSI in unadjusted comparisons. In the multivariate model, the CCI (odds ratio 1.58, 95% CI 1.25-1.99; P<.001) and use of CPB (odds ratio 4.89, 95% CI 1.71-13.94; P=.003) were independently associated with SSI.
CONCLUSIONS: The CCI and the use of CPB were independently associated with SSI.
OBJECTIVE: This study aimed to identify perioperative variables associated with SSI in patients with frailty and prefrailty undergoing coronary artery bypass grafting within 30 days of the procedure.
METHODS: This retrospective observational study included 467 patients with frailty or prefrailty aged 60 years and older who underwent coronary artery bypass grafting in 6 Brazilian centers between January 2018 and December 2024. Frailty was defined using the Fried criteria. SSI was defined as a wound with exposed tissue with positive culture requiring antibiotic treatment. Univariate and multivariate analyses were carried out.
RESULTS: The rate of SSI was 5.6% (26/467). The New York Heart Association classification (P=.02), Charlson Comorbidity Index (CCI; P=.01), use of cardiopulmonary bypass (CPB; P=.003), CPB time (P=.02), total surgery time (P<.001), occurrence of bleeding (P=.04), mechanical ventilation time (P=.001), length of hospital stay (P<.001), intensive care unit stay (P<.001), and need for reoperation (P<.001) variables were associated with SSI in unadjusted comparisons. In the multivariate model, the CCI (odds ratio 1.58, 95% CI 1.25-1.99; P<.001) and use of CPB (odds ratio 4.89, 95% CI 1.71-13.94; P=.003) were independently associated with SSI.
CONCLUSIONS: The CCI and the use of CPB were independently associated with SSI.