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Published on: November 19, 2019
Risk factors for leg harvest surgical site infections after coronary artery bypass graft surgery
Margaret A Olsen1, Thoralf M Sundt, Jennifer S Lawton
1Washington University School of Medicine, Division of Infectious Diseases, 660 South Euclid Ave, Campus Box 8051, St Louis, MO 63110-1093, USA. molsen@im.wustl.edu
Insights
Leg harvest site infections after coronary artery bypass surgery are common. Risk factors include previous stroke, obesity, older age, female gender, and transfusions, impacting hospital stay and readmission.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease Epidemiology
- Health Informatics
Background:
- Leg harvest site infections are a significant concern following coronary artery bypass surgery (CABS).
- Limited research exists on the specific risk factors for these infections.
- Understanding these predictors is crucial for patient management and prevention strategies.
Purpose of the Study:
- To identify independent risk factors for leg harvest site infections after CABS.
- To utilize the institutional Society of Thoracic Surgeons database for this analysis.
Main Methods:
- Retrospective analysis of 1980 CABS patients from January 1996 to June 1999.
- Data sourced from The Society of Thoracic Surgeons database.
- Multivariate logistic regression employed to determine independent risk factors.
Main Results:
- 4.5% of patients developed leg harvest site infections (67 confirmed).
- Infected patients had longer hospital stays (10.1 vs. 7.1 days) and higher readmission rates.
- Independent risk factors identified: previous cerebrovascular accident (OR 2.9), >=5 units RBC transfusion (OR 2.8), obesity (OR 2.5), age >=75 (OR 1.9), and female gender (OR 1.8).
Conclusions:
- Confirms obesity and female gender as risk factors for leg harvest site infection.
- Newly identified risk factors include previous cerebrovascular accident, significant red blood cell transfusion, and advanced age.
- The Society of Thoracic Surgeons database is valuable for identifying infection predictors.
Objective:
Harvest site infections are more common than chest surgical infections after coronary artery bypass surgery, yet few studies detail risk factors for these infections. We sought to determine independent risk factors for leg surgical site infections using our institutional Society of Thoracic Surgeons database.
Methods:
We retrospectively analyzed data collected from 1980 coronary artery bypass patients undergoing surgery at our institution from January 1, 1996, through June 30, 1999, using The Society of Thoracic Surgeons database. Independent risk factors for leg harvest site infection were identified by multivariate logistic regression.
Results:
Seventy-six patients (4.5%) were coded as having had a leg harvest site infection, of which 67 were confirmed by infection control. The length of hospital stay after surgery was significantly longer in patients with leg harvest site infection (mean 10.1 days) compared with that of patients without infection (mean 7.1 days, P <.001), and infected patients were more likely to be readmitted to the hospital within 30 days of surgery. Independent risk factors for leg harvest site infection included previous cerebrovascular accident (odds ratio, 2.9), postoperative transfusion of 5 units or more of red blood cells (odds ratio, 2.8), obesity (odds ratio, 2.5), age 75 years or older (odds ratio, 1.9), and female gender (odds ratio, 1.8).
Conclusions:
Consistent with previous studies, female gender and obesity were identified as independent risk factors for leg harvest site infection, while previous cerebrovascular accident, postoperative transfusion, and older age are newly described risk factors. The Society of Thoracic Surgeons database is a useful tool for identification of predictors of leg harvest site infections.
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