Risk factors for surgical site infections following open-heart surgery in a Canadian pediatric population

Background The rate and risk factors for surgical site infections (SSIs) in pediatric cardiac patients have not been well delineated. Methods All patients aged <18 years who had open-heart surgery at the Stollery Childrenʹs Hospital in the 1998–2002 period were followed. A case-control study was performed to examine risk factors for SSI. Controls were matched to cases according to National Nosocomial Surveillance System risk scores, age, and year of surgery. Results SSI incidence was 3.4% (0.9% superficial wound infections, .1% deep incisional surgical site infections, and 2.4% organ space surgical site infections). In the case-control study, the only risk factor that was statistically significant was the duration of surgery. There was a trend toward an increased incidence of SSI (P < .25) for children with failure to thrive, or for those who required inotropes or had an elevated serum lactate in the first 24 hours postoperation. Conclusion In pediatric cardiac surgery, the risk of SSI increases with the duration of surgery. There is a need for prospective studies of potentially modifiable risk factors.