Análise da ocorrência de infecção de sítio cirúrgico em pacientes submetidos à cirurgia cardíaca.

Abstract

Surgical site infections (SSIs) in cardiac surgery, although infrequent, are considered to be a great complication both for the patient and the professional team. They present a high level of morbid-mortality and considerably increase hospital costs during treatment. The objective of this study is to analyse the occurrence of surgical site infections in patients who underwent cardiac surgery between July 2005 and July 2010. This is a retrospective longitudinal study with a quantitative approach. The data was obtained from patients medical histories and notifiable disease report forms from a large University Hospital. The population consisted of 384 patients. In order to obtain the data, an instrument was used which considered clinical and related epidemiological variables related to the risk factors for the appearance of SSIs. In the processing and analysis of the data the software Statistical Package for the Social Sciences (SPSS) was used. Descriptive analyses, measures of association in contingency tables, and logistic regression were carried out. With a view to verifying if there was an association between SSI and categorical variables, a chi-square test was carried out, as well as Fisher s Exact Test. In order to verify the average time it took for SSI to occur during the patients stay in hospital post-op, a Student s T Test was used. This study is part of a larger project, registered at the Ethical Committee for Research at UFTM, project nº 1611, approved. It was observed that of the 384 patients, 36 (9.4%) contracted an SSI, and in those patients the mortality rate was 14 (38.9%). Staphylococcus aureus was the most common micro-organism 12 (27.3%) and the antibiotic therapy administered was using Cefepime Hydrochloride, 25 (21.6%). There was statistical significance (p<0.05) between SSI and sex, DM, COPD, type of surgical procedure, duration of surgery, duration of intubation, re-intubation, time of stay in ICU (average 19.08 days) and total stay post-op (average 33 days). The risk factors identified as triggers (p<0.05 in the multivariate analysis) for SSI were male gender, duration of intubation over 24 hours, and re-intubation. In conclusion, in male patients intubated for over 24 hours who were also re-intubated had an increased risk for developing an SSI (p<0.05). The results of this study highlight the need for the development of prevention strategies, controls and monitoring of this infection with an aim to reduce incidence and guarantee the welfare of the patient.