RISK FEATURES FOR SURGICAL-SITE INFECTIONS IN CORONARY-ARTERY BYPASS-SURGERY

OBJECTIVE: To identify preoperative and perioperative features that ma y lead to a risk of surgical-site infection (SSI) after coronary arter y bypass surgery. DESIGN: 884 patients who underwent coronary artery b ypass grafting in 1992 and 1993 were studied. The associations between 23 preoperative and perioperative features and the presence of SSI at the donor site or in the chest area were evaluated by univariate anal ysis followed by multivariate logistic regression analysis. SETTING: A university hospital. RESULTS: 172 patients (19.5%) either had an SSI recorded before discharge or had received antibiotics prescribed for a suspected SSI during the 1-month surveillance period after discharge. Multivariate logistic regression analysis showed an extreme body mass index (BMI; P=.015), female gender (P=.023), and chronic obstructive pulmonary disease (COPD; P=.030) to be independent risk features for S SI. The donor site was infected in 136 patients (15.4%), an event for which female gender (P=.003) was the only independent risk feature. Fo rty-seven patients (5.3%) had an SSI of the chest area, with diabetes (P=.003) and extreme BMI (P=.010) as independent risk features. CONCLU SION: Extreme BMI, female gender, and COPD are highly significant inde pendent predictors of the development of SSI. Female gender is a risk feature specifically for SSI at the donor site, whereas diabetes and e xtreme BMI predict it in the chest area (Infect Control Hosp Epidemiol 1998;19:240-247).