Infección nosocomial en el postoperatorio inmediato del trasplante cardiacofactores de riesgo y tendencia temporal

Abstract

OBJECTIVES: The aim of this study was to identify specific risk factors for early postoperative infections in heart transplantation recipients, and to develop a multivariable predictive model to identify patients at high risk. METHODS: A single-centre, observational, retrospective study was conducted. The dependent variable was in-hospital postoperative infection. We examined demographic and epidemiological data from donor and recipients, surgical features and adverse postoperative events as independent variables. Backward, stepwise multivariable logistic regression with a p-value < 0.05 was used to identify clinical factors independently associated with the risk of postoperative infections. RESULTS: 677 patients were included. During the in-hospital postoperative period, 348 episodes of infection were diagnosed in 239 patients. Seven variables were identified as independent clinical predictors of early postoperative infection: diabetes mellitus, previous sternotomy, preoperative mechanical ventilation, primary graft failure, major surgical bleeding, use of mycophenolate mofetil and itraconazole. Base don these results, we constructed a score to predict the risk of in-hospital postoperative infection, which showed a reasonable ability to predict it. CONCLUSIONS: In-hospital postoperative infection is a common complication after heart transplantation. Diabetes mellitus, previous sternotomy, preoperative mechanical ventilation, primary graft failure, major surgical bleeding, mycophenolate mofetil and itraconazole were all independent clinical predictors of early postoperative infection