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Influence of perioperative variables on surgical site infection in patients with frailty undergoing coronary artery bypass grafting: retrospective, multicenter study
ABSTRACT
Background:
Surgical site infection in patients with frailty undergoing myocardial revascularization is a major clinical challenge, and there is a gap in the literature related to this topic.
Objective:
This study aims to identify perioperative variables associated with surgical site infection in patients with frailty undergoing coronary artery bypass grafting, within 30 days of the procedure.
Methods:
This retrospective observational study included 467 patients with frailty aged ≥60 years who underwent coronary artery bypass grafting in six Brazilian centers between January 2018 and December 2024. Frailty was defined using Fried criteria. Surgical site infection was defined as a wound with exposed tissue with positive culture, requiring antibiotic treatment. Univariate and multivariate analyses were carried out.
Results:
The rate of surgical site infection was 6%. The variables NYHA classification (P=0,024), Charlson Comorbidity Index (CCI) (P=0,012), use of cardiopulmonary bypass (CPB) (P=0,003), CPB time (P=0,024), total surgery time (P<0,001), occurrence of bleeding (P=0,039), mechanical ventilation time (P=0,001), length of hospital stay (P<0,001), ICU stay (P<0,001), and need for reoperation (P<0,001) were associated with a higher incidence of infection. In the multivariate model, the CCI (odds ratios (OR) = 1.58; 95%CI: 1.25–1.99; P < 0.001) and the use of CPB (OR = 4.89; 95%CI: 1.71–13.94; P = 0.003) were significantly associated with a higher risk surgical site infection.
Conclusions:
The CCI and the use of CPB are independent predictors of surgical site infection.
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