Transient liver dysfunction increases surgical site infections after coronary surgery

Area of Science:

• Cardiology
• Hepatology
• Infectious Disease

Background:

• Surgical site infections (SSIs) negatively impact cardiac surgery outcomes.
• The liver is crucial for infection prevention.
• The relationship between postoperative liver dysfunction and SSIs after coronary bypass surgery (CBS) requires investigation.

Purpose of the Study:

• To retrospectively assess if transient postoperative liver dysfunction following coronary bypass surgery is associated with an increased incidence of surgical site infections.

Main Methods:

• A modified Schindl scoring scale quantified transient liver dysfunction within 7 days post-on-pump coronary artery bypass grafting.
• Retrospective analysis of 575 patients undergoing coronary bypass between 2014-2016, with 30-month follow-up.
• Patients were grouped into liver dysfunction (Schindl score ≥ 4) and non-liver dysfunction (Schindl score < 4) categories.

Main Results:

• The liver dysfunction group exhibited higher rates of obesity, smoking, diabetes, renal impairment, and peripheral vascular disease.
• Surgical site infections were significantly more prevalent in the liver dysfunction group (12.1% vs. 0.3%, p < 0.001).
• Independent predictors for SSI included liver dysfunction, obesity (BMI > 30 kg/m²), and combined cardiac procedures with CBS.

Conclusions:

• Multiple factors contribute to surgical wound infections in coronary bypass surgery patients.
• Perioperative transient liver dysfunction is an independent risk factor for increased surgical site infections.
• Incorporating liver dysfunction assessment may improve patient risk stratification for SSIs post-cardiac surgery.