The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care
Although diabetes is a recognized risk factor for postoperative infections, the seminal Portland Diabetic Project studies in cardiac surgery demonstrated intravenous insulin infusions following open-cardiac surgery achieved near normal glycaemia and decreased deep sternal wound infection to similar...
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| Veröffentlicht in: | The Journal of hospital infection 2021-10, Vol.116, p.47-52 |
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| container_title | The Journal of hospital infection |
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| creator | Cheuk, N. Worth, L.J. Tatoulis, J. Skillington, P. Kyi, M. Fourlanos, S. |
| description | Although diabetes is a recognized risk factor for postoperative infections, the seminal Portland Diabetic Project studies in cardiac surgery demonstrated intravenous insulin infusions following open-cardiac surgery achieved near normal glycaemia and decreased deep sternal wound infection to similar rates to those without diabetes.
We sought to examine a contemporary cohort of patients undergoing coronary artery bypass graft surgery (CABGS) to evaluate the relationship between diabetes, hyperglycaemia and risk of surgical site infection (SSI) in current-era models of care.
Consecutive patients who underwent CABGS between 2016 and 2018 were identified through a state-wide data repository for healthcare-associated infections. Clinical characteristics and records of postoperative SSIs were obtained from individual chart review. Type 2 diabetes (T2D), perioperative glycaemia and other clinical characteristics were analysed in relation to the development of SSI.
Of the 953 patients evaluated, 11% developed SSIs a median eight days post CABGS, with few cases of deep SSIs ( |
| doi_str_mv | 10.1016/j.jhin.2021.07.009 |
| format | Article |
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We sought to examine a contemporary cohort of patients undergoing coronary artery bypass graft surgery (CABGS) to evaluate the relationship between diabetes, hyperglycaemia and risk of surgical site infection (SSI) in current-era models of care.
Consecutive patients who underwent CABGS between 2016 and 2018 were identified through a state-wide data repository for healthcare-associated infections. Clinical characteristics and records of postoperative SSIs were obtained from individual chart review. Type 2 diabetes (T2D), perioperative glycaemia and other clinical characteristics were analysed in relation to the development of SSI.
Of the 953 patients evaluated, 11% developed SSIs a median eight days post CABGS, with few cases of deep SSIs (<1%). T2D was evident in 41% and more prevalent in those who developed SSIs (51%). On multivariate analysis T2D was not significantly associated with development of SSI (odds ratio (OR) 1.35; P=0.174) but body mass index (BMI) remained a significant risk factor (OR 1.07, P<0.001). In patients with T2D, perioperative glycaemia was not significantly associated with SSI.
In a specialist cardiac surgery centre using perioperative intravenous insulin infusions and antibiotic prophylaxis, deep SSIs were uncommon; however, approximately one in 10 patients developed superficial SSIs. T2D was not independently associated with SSI yet BMI was independently associated with SSI post CABGS.</description><identifier>ISSN: 0195-6701</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2021.07.009</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>Bypass ; Coronary ; Diabetes ; Graft ; Infection ; Surgery</subject><ispartof>The Journal of hospital infection, 2021-10, Vol.116, p.47-52</ispartof><rights>2021 The Healthcare Infection Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c333t-304141d792739f3543b90a35b3f28118d80fe6ace582f4bac2b101ec56b852263</citedby><cites>FETCH-LOGICAL-c333t-304141d792739f3543b90a35b3f28118d80fe6ace582f4bac2b101ec56b852263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhin.2021.07.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids></links><search><creatorcontrib>Cheuk, N.</creatorcontrib><creatorcontrib>Worth, L.J.</creatorcontrib><creatorcontrib>Tatoulis, J.</creatorcontrib><creatorcontrib>Skillington, P.</creatorcontrib><creatorcontrib>Kyi, M.</creatorcontrib><creatorcontrib>Fourlanos, S.</creatorcontrib><title>The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care</title><title>The Journal of hospital infection</title><description>Although diabetes is a recognized risk factor for postoperative infections, the seminal Portland Diabetic Project studies in cardiac surgery demonstrated intravenous insulin infusions following open-cardiac surgery achieved near normal glycaemia and decreased deep sternal wound infection to similar rates to those without diabetes.
We sought to examine a contemporary cohort of patients undergoing coronary artery bypass graft surgery (CABGS) to evaluate the relationship between diabetes, hyperglycaemia and risk of surgical site infection (SSI) in current-era models of care.
Consecutive patients who underwent CABGS between 2016 and 2018 were identified through a state-wide data repository for healthcare-associated infections. Clinical characteristics and records of postoperative SSIs were obtained from individual chart review. Type 2 diabetes (T2D), perioperative glycaemia and other clinical characteristics were analysed in relation to the development of SSI.
Of the 953 patients evaluated, 11% developed SSIs a median eight days post CABGS, with few cases of deep SSIs (<1%). T2D was evident in 41% and more prevalent in those who developed SSIs (51%). On multivariate analysis T2D was not significantly associated with development of SSI (odds ratio (OR) 1.35; P=0.174) but body mass index (BMI) remained a significant risk factor (OR 1.07, P<0.001). In patients with T2D, perioperative glycaemia was not significantly associated with SSI.
In a specialist cardiac surgery centre using perioperative intravenous insulin infusions and antibiotic prophylaxis, deep SSIs were uncommon; however, approximately one in 10 patients developed superficial SSIs. T2D was not independently associated with SSI yet BMI was independently associated with SSI post CABGS.</description><subject>Bypass</subject><subject>Coronary</subject><subject>Diabetes</subject><subject>Graft</subject><subject>Infection</subject><subject>Surgery</subject><issn>0195-6701</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOwzAQRS0EEqXwA6y8ZJPgR52HxAZVvKRKbMracpxx6yi1g51S9Rf4ahzKmtUdjc4daQ5Ct5TklNDivsu7rXU5I4zmpMwJqc_QjArOMlbz-hzNCK1FVpSEXqKrGDuSCF6LGfpebwEH6NVovYtbO-AGxgOAw61VaYSIlWtx3IeN1arH0Y6ArTOgpwI2vu_9wboN1j54p8IRqzBCiuY4qBjxJigz_tanpXVY70MAN2YQFN75FvqIvcFaBbhGF0b1EW7-co4-np_Wy9ds9f7ytnxcZZpzPmacLOiCtmXNSl4bLha8qYniouGGVZRWbUUMFEqDqJhZNEqzJikCLYqmEowVfI7uTneH4D_3EEe5s1FD3ysHfh8lE6JMXMFFQtkJ1cHHGMDIIdhd-lJSIifxspOTeDmJl6SUk9Y5ejiV0m_wZSHIqC04Da0NSZtsvf2v_gOZyo79</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Cheuk, N.</creator><creator>Worth, L.J.</creator><creator>Tatoulis, J.</creator><creator>Skillington, P.</creator><creator>Kyi, M.</creator><creator>Fourlanos, S.</creator><general>Elsevier Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202110</creationdate><title>The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care</title><author>Cheuk, N. ; Worth, L.J. ; Tatoulis, J. ; Skillington, P. ; Kyi, M. ; Fourlanos, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c333t-304141d792739f3543b90a35b3f28118d80fe6ace582f4bac2b101ec56b852263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bypass</topic><topic>Coronary</topic><topic>Diabetes</topic><topic>Graft</topic><topic>Infection</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheuk, N.</creatorcontrib><creatorcontrib>Worth, L.J.</creatorcontrib><creatorcontrib>Tatoulis, J.</creatorcontrib><creatorcontrib>Skillington, P.</creatorcontrib><creatorcontrib>Kyi, M.</creatorcontrib><creatorcontrib>Fourlanos, S.</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hospital infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheuk, N.</au><au>Worth, L.J.</au><au>Tatoulis, J.</au><au>Skillington, P.</au><au>Kyi, M.</au><au>Fourlanos, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care</atitle><jtitle>The Journal of hospital infection</jtitle><date>2021-10</date><risdate>2021</risdate><volume>116</volume><spage>47</spage><epage>52</epage><pages>47-52</pages><issn>0195-6701</issn><eissn>1532-2939</eissn><abstract>Although diabetes is a recognized risk factor for postoperative infections, the seminal Portland Diabetic Project studies in cardiac surgery demonstrated intravenous insulin infusions following open-cardiac surgery achieved near normal glycaemia and decreased deep sternal wound infection to similar rates to those without diabetes.
We sought to examine a contemporary cohort of patients undergoing coronary artery bypass graft surgery (CABGS) to evaluate the relationship between diabetes, hyperglycaemia and risk of surgical site infection (SSI) in current-era models of care.
Consecutive patients who underwent CABGS between 2016 and 2018 were identified through a state-wide data repository for healthcare-associated infections. Clinical characteristics and records of postoperative SSIs were obtained from individual chart review. Type 2 diabetes (T2D), perioperative glycaemia and other clinical characteristics were analysed in relation to the development of SSI.
Of the 953 patients evaluated, 11% developed SSIs a median eight days post CABGS, with few cases of deep SSIs (<1%). T2D was evident in 41% and more prevalent in those who developed SSIs (51%). On multivariate analysis T2D was not significantly associated with development of SSI (odds ratio (OR) 1.35; P=0.174) but body mass index (BMI) remained a significant risk factor (OR 1.07, P<0.001). In patients with T2D, perioperative glycaemia was not significantly associated with SSI.
In a specialist cardiac surgery centre using perioperative intravenous insulin infusions and antibiotic prophylaxis, deep SSIs were uncommon; however, approximately one in 10 patients developed superficial SSIs. T2D was not independently associated with SSI yet BMI was independently associated with SSI post CABGS.</abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.jhin.2021.07.009</doi><tpages>6</tpages></addata></record> |
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| ispartof | The Journal of hospital infection, 2021-10, Vol.116, p.47-52 |
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| language | eng |
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| subjects | Bypass Coronary Diabetes Graft Infection Surgery |
| title | The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care |
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