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Pneumonia Most Common Infection After Heart Surgery

New research shows it’s pneumonia, rather than an infection from the deep incision surgical site, that is the most common serious infection after heart surgery.

And most of these infections occur about two weeks after surgery, according to the study by the American Heart Association. Physicians had previously thought it was one week.

The results of the study were “not what we expected,“ said Dr. Michael A. Acker, lead author of the study and chief of cardiovascular surgery and professor at the University of Pennsylvania Medical Center in Philadelphia, Pa.

Researchers analyzed 5,100 patients in a heart surgery registry for this study. The average age of these patients was 64 and they were treated at nine U.S. academic medical centers and one Canadian center.

The median time to major infection was approximately 14 days after heart surgeries, with 43 percent of infections occurring after hospital discharge.

“Half of these patients had no evidence of infection before they were discharged from the hospital,” Dr, Acker said in a news release. “Then they had to return to the hospital because of the new infection.”

The results of the study show that patients must be followed more closely after they are discharged, researchers say.

In this study researchers found 761 infections, with 300 classified as major infections (occurring in 6 percent of patients) and 461 were minor (in 8.1 percent of patients). Patients who were infected before surgery were excluded from this study.

The breakdown of the major infections included:

• Pneumonia, infection of the lungs, occurred in 2.4 percent of all patients.
• C. difficile colitis, an intestinal infection, occurred in 1 percent.
• Bloodstream infections were found in 1.1 percent.
• Deep-incision surgical site infections occurred in 0.5 percent.

Minor infections included superficial incision site infections and urinary tract infections.

The most commonly performed surgical procedures were isolated coronary artery bypass graft and mitral and aortic valve surgeries. Elective surgeries accounted for 74 percent of the procedures and 26 percent were non-elective or emergency surgeries.

The following factors were identified as increasing the risk of developing infection, including chronic lung disease, hypertension, congestive heart failure, corticosteroid use prior to surgery, and length of cardiopulmonary bypass time.

Researchers say they will next focus on the differences in care, from the type of antibiotics and surgical preparations to the types of dressings that were used, to show which are associated with fewer infections.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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