PREventie van ZIEkenhuisinfecties door Surveillance.Component wondinfecties na hartchirurgie, pilotstudie 2001-2002

摘要

Yearly, about 14,000 patients undergo open heart surgery at one of the 13specialized heart centres in the Netherlands. Since surgical siteinfections can occur as a complication, surveillance of these infectionsis an important tool for prevention. In 2001/2002 a pilot study wascarried out in seven Dutch heart centres to test a standardizedregistration method for wound infections after heart surgery. Additionally, the study was to assess which risk factors should beadjusted for to allow comparison of infection rates among the centres. Adefinitive protocol for the surveillance of wound infections after heartsurgery has now been established on the basis of the results of thispilot study. For the study the heart centres collected information on1612 open heart operations and on the infection prevention policy foropen heart surgery. Twenty-one deep sternal wound infections (incidence1.3%) and 24 superficial sternal wound infections (incidence 1.5%) occurred. Of the 1013 patients with a leg graft, 43 contracted a woundinfection at the harvest site (incidence 4.2%). About 50% of the sternalwound infections and 84% of the donor wound infections were contractedafter discharge from the heart centre. Patients with a longer follow-upperiod after the operation were more often recognized as having a woundinfection. The most important risk factors for contracting an infectionwere higher age, being female, higher body mass index, havinginsulin-dependent diabetes, longer perfusion time, higher lowest bodytemperature during the operation, and undergoing an emergency operationor a resternotomy after the original operation. These risk factors canbe used to generate reference data for wound infections after heartsurgery, which are adjusted for the most important confoundingfactors.