Abstract
ObjectiveTo assess the impact of respiratory tract infection in the postoperative period of cardiac surgery in relation to mortality and to identify patients at higher risk of developing this complication.MethodsCross-sectional observational study conducted at the Recovery of Cardiothoracic Surgery, using information from a database consisting of a total of 900 patients operated on in this hospital during the period from 01/07/2008 to 1/07/2009. We included patients whose medical records contained all the information required and undergoing elective surgery, totaling 109 patients with two excluded. Patients were divided into two groups, WITH and WITHOUT respiratory tract infection, as the development or respiratory tract infection in hospital, with patients in the group without respiratory tract infection, the result of randomization, using for the pairing of the groups the type of surgery performed. The outcome variables assessed were mortality, length of hospital stay and length of stay in intensive care unit. The means of quantitative variables were compared using the Wilcoxon and student t-test.ResultsThe groups were similar (average age P=0.17; sex P=0.94; surgery performed P=0.85-1.00) Mortality in the WITH respiratory tract infection group was significantly higher (P<0.0001). The times of hospitalization and intensive care unit were significantly higher in respiratory tract infection (P<0.0001). The presence of respiratory tract infection was associated with the development of other complications such as renal failure dialysis and stroke P<0.00001 and P=0.002 respectively.ConclusionThe development of respiratory tract infection postoperative cardiac surgery is related to higher mortality, longer periods of hospitalization and intensive care unit stay.
Highlights
In Brazil, more than 100,000 heart surgeries are performed each year[1]
The times of hospitalization and intensive care unit were significantly higher in respiratory tract infection (P
The presence of respiratory tract infection was associated with the development of other complications such as renal failure dialysis and stroke P
Summary
In Brazil, more than 100,000 heart surgeries are performed each year[1]. In Recife, at Real Hospital Português de Beneficência in Pernambuco (RHP) only, 1,400 surgeries are performed every year, demonstrating the significance of the procedure in our country. Three major events, when present, increase the chances of death: the development of respiratory infection, perioperative stroke and renal failure dialysis (RFD)[2,3], Besides associated with higher mortality, such occurrences are important causes of readmission to the intensive care unit, increasing hospital costs[4]. An important determinant of bad results in cardiac surgery is the infection[5], especially the respiratory infection, the most frequent in this type of procedure - it exceeds 50% of high mortality infections[6]. It is known that the early identification of patients at higher risk of developing this complication and the adoption of prophylactic measures can reduce the mortality rate significantly[7,8,9]
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