دورية أكاديمية

The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care.

التفاصيل البيبلوغرافية
العنوان: The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care.
المؤلفون: Cheuk, N., Worth, L.J., Tatoulis, J., Skillington, P., Kyi, M., Fourlanos, S., N, Cheuk, Lj, Worth, J, Tatoulis, P, Skillington, M, Kyi, S, Fourlanos
المصدر: Journal of Hospital Infection; Oct2021, Vol. 116, p47-52, 6p
مستخلص: Background: Although diabetes is a recognized risk factor for postoperative infections, the seminal Portland Diabetic Project studies in cardiac surgery demonstrated intravenous insulin infusions following open-cardiac surgery achieved near normal glycaemia and decreased deep sternal wound infection to similar rates to those without diabetes.Aim: We sought to examine a contemporary cohort of patients undergoing coronary artery bypass graft surgery (CABGS) to evaluate the relationship between diabetes, hyperglycaemia and risk of surgical site infection (SSI) in current-era models of care.Methods: Consecutive patients who underwent CABGS between 2016 and 2018 were identified through a state-wide data repository for healthcare-associated infections. Clinical characteristics and records of postoperative SSIs were obtained from individual chart review. Type 2 diabetes (T2D), perioperative glycaemia and other clinical characteristics were analysed in relation to the development of SSI.Findings: Of the 953 patients evaluated, 11% developed SSIs a median eight days post CABGS, with few cases of deep SSIs (<1%). T2D was evident in 41% and more prevalent in those who developed SSIs (51%). On multivariate analysis T2D was not significantly associated with development of SSI (odds ratio (OR) 1.35; P=0.174) but body mass index (BMI) remained a significant risk factor (OR 1.07, P<0.001). In patients with T2D, perioperative glycaemia was not significantly associated with SSI.Conclusion: In a specialist cardiac surgery centre using perioperative intravenous insulin infusions and antibiotic prophylaxis, deep SSIs were uncommon; however, approximately one in 10 patients developed superficial SSIs. T2D was not independently associated with SSI yet BMI was independently associated with SSI post CABGS. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Supplemental Index
الوصف
تدمد:01956701
DOI:10.1016/j.jhin.2021.07.009