Predictors of Postoperative Hospital-Acquired Infection and Mortality Following Cardiac Surgery in a Low-Income Country: A Retrospective Cohort Study.

Abstract

Introduction: Recognizing the risk factors for postoperative hospital-acquired infection and mortality is crucial for better outcomes. We aimed to determine the risk predictors for postoperative hospital-acquired infection and death following cardiac surgery.

Methods: This is a retrospective cohort study that included 880 consecutive adult patients who underwent cardiac surgery between 2015 and 2021. Multivariable logistic regression was performed to assess the predictors of postoperative hospital-acquired infection and mortality.

Results: Patients who developed postoperative hospital-acquired infection had higher values on European System for Cardiac Operative Risk Evaluation score (4.01% vs. 2.51%; P=0.001), as well as longer hospital preoperative stay (9.44 vs. 8.28 days; P=0.049) and hospital length of stay (28.41 vs. 16.16 days; P<0.001). After multivariable analysis, predictors of postoperative hospital-acquired infection were longer hospital preoperative stay (odds ratio 1.024; 95% confidence interval 1.005-1.044; P=0.009), higher body mass index (odds ratio 1.043; 95% confidence interval 1.008-1.079; P=0.015), and longer extracorporeal circulation time (odds ratio 1.007; 95% confidence interval 1.003-1.012; P<0.001). Both longer extracorporeal circulations time and postoperative hospital-acquired infection were significantly associated with higher mortality before hospital discharge (odds ratio 1.012; 95% confidence interval 1.006-1.019; P<0.001; and odds ratio 2.418; 95% confidence interval 1.385-4.233; P=0.001, respectively).

Conclusion: Extended preoperative hospitalization, body mass index, and extracorporeal circulation time are correlated with heightened postoperative hospital-acquired infection rates. Moreover, longer extracorporeal circulation time and postoperative hospital-acquired infection incidence emerged as significant predictors of mortality following cardiac surgery.