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. 2020 Jan 21;20(1):64.
doi: 10.1186/s12879-020-4769-6.

Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

Xindi Yu  1 , Maolin Chen  1 , Xu Liu  1 , Yiwei Chen  2 , Zedong Hao  2 , Haibo Zhang  3 , Wei Wang  4
Affiliations

Risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease

Xindi Yu et al. BMC Infect Dis. .

Abstract

Background: The aim of our study was to analyze the risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease (CHD).

Methods: We performed a retrospective cohort study, and children with CHD who underwent open-heart surgeries at Shanghai Children's Medical Center from January 1, 2012 to December 31, 2018 were included. The baseline characteristics of these patients of different ages, including neonates (0-1 months old), infants (1-12 months old) and children (1-10 years old), were analyzed, and the association of risk factors with postoperative nosocomial infection were assessed.

Results: A total of 11,651 subjects were included in the study. The overall nosocomial infection rate was 10.8%. Nosocomial infection rates in neonates, infants, and children with congenital heart disease were 32.9, 15.4, and 5.2%, respectively. Multivariate logistic regression analysis found age (OR 0798, 95%CI: 0.769-0.829; P < 0.001), STS risk grade (OR 1.267, 95%CI: 1.159-1.385; P < 0.001), body mass index (BMI) <5th percentile (OR 1.295, 95%CI: 1.023-1.639; P = 0.032), BMI >95th percentile (OR 0.792, 95%CI: 0.647-0.969; P = 0.023), cardiopulmonary bypass (CPB) time (OR 1.008, 95%CI: 1.003-1.012; P < 0.001) and aortic clamping time (OR 1.009, 1.002-1.015; P = 0.008) were significantly associated with nosocomial infection in CHD infants. After adjusted for confounding factors, we found STS risk grade (OR 1.38, 95%CI: 1.167-1.633; P < 0.001), BMI < 5th percentile (OR 1.934, 95%CI: 1.377-2.715; P < 0.001), CPB time (OR 1.018, 95%CI: 1.015-1.022; P < 0.001), lymphocyte/WBC ratio<cut off value (OR 3.818, 95%CI: 1.529-9.533; P = 0.004) and AST>cut off value (OR 1.546, 95%CI: 1.119-2.136; P = 0.008) were significantly associated with nosocomial infection in CHD children.

Conclusion: Our study suggested STS risk grade, BMI, CPB duration, low lymphocyte/WBC or high neutrophil/WBC ratio were independently associated with nosocomial infection in CHD infant and children after cardiac surgery.

Keywords: Cardiac surgery; Children; Nosocomial infection.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Nomograms predicting nosocomial infection risk of CHD infant after cardiac surgery
Fig. 2
Fig. 2
The area under the curve of nomograms predicting nosocomial infection risk of CHD infant after cardiac surgery
Fig. 3
Fig. 3
Nomograms predicting nosocomial infection risk of CHD children after cardiac surgery
Fig. 4
Fig. 4
The area under the curve of nomograms predicting nosocomial infection risk of CHD children after cardiac surgery
See this image and copyright information in PMC

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