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Correlated factors for device-associated health care-associated infections after cardiac surgery: a retrospective cohort study

anesthesiology-and-pain-management
cardiology
emergency-and-critical-care
healthcare-services

Abstract

Background. To identify the correlated factors associated with developing device-associated health care-associated infections (DA-HAIs) in the cardiac intensive care unit (CICU).

Methods. We designed a retrospective single-center cohort study in the CICU at a tertiary referral hospital. The study reviewed all adult patients who underwent cardiac surgery between January 2020 and December 2023. Patients who developed DA-HAIs in CICU were compared with matched controls who did not experience infections. Data were collected from patient records, and both univariate and multivariate logistic regression analyses were performed to identify independent predictive factors for DA-HAIs in CICU. Predictive factors were analyzed in correlation to both clinical and procedural variables.

Results. In total, 89 patients who developed DA-HAIs were identified, and 178 matched controls were included for comparison. Multivariate analysis revealed several significant risk factors for DA-HAIs in CICU. Prolonged cardiopulmonary bypass (CPB) time over 2 hours was identified as an independent risk factor, with an odds ratio (OR) and 95% confidence interval (CI) of 7.153, 2.216–23.091. Prolonged postoperative mechanical ventilation beyond 7 days was associated with a higher risk of DA-HAIs (OR: 13.103, 95% CI: 2.093–82.016 ). A medical history of valvular surgery (OR: 0.003, 95% CI: 0–0.028), the diagnosis of aortic dissection (OR: 0.006, 95% CI: 0–0.073) and the type of coronary artery bypass grafting surgery (OR: 0.053, 95% CI: 0.013–0.218) were found to have protective effect, with patients having a significantly lower likelihood of developing.

Conclusions. This study highlighted key clinical and procedural factors associated with DA-HAIs in cardiac surgery patients. Extended CPB time, prolonged ventilation, valvular surgical history, diagnosis of aortic dissection, and coronary artery bypass grafting surgery were significant predictors. These findings emphasized the importance of targeted preventive measures, such as early extubation and careful attention to medical history, to reduce the risk of DA-HAIs in CICU. Future studies with larger cohorts and multicenter designs are needed to validate these findings further and refine infection prevention strategies.

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