Evaluation of nosocomial infections after congenital heart surgery in children: A comprehensive analysis including the systemic immune-inflammation index (SII) - Summary - MDSpire
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Evaluation of nosocomial infections after congenital heart surgery in children: A comprehensive analysis including the systemic immune-inflammation index (SII)
To identify independent risk factors for nosocomial infections (NIs) and evaluate the predictive utility of the Systemic Immune-Inflammation Index (SII) in pediatric patients post-cardiac surgery.
Key Findings:
NIs were observed in 46 patients (22.0%), with sepsis (69.6%) and pneumonia (30.4%) being the most frequent types.
Gram-negative bacteria predominated in infections (58.4%).
Patients with NI were significantly younger, had more cyanotic CHD, comorbidities, and higher Aristotle scores.
Postoperative SII was significantly lower in the infection group (562.73 vs. 916.28; p<0.001).
Four independent predictors of increased NI risk were identified: younger age, mechanical ventilation duration, postoperative length of stay, and presence of postoperative complications.
Interpretation:
Postoperative complications are the strongest independent predictor for NIs following pediatric cardiac surgery. Prolonged mechanical ventilation and postoperative length of stay significantly increase this risk. While SII correlates negatively with infection status, it does not serve as a robust independent predictor in this population.
Limitations:
The study is retrospective and conducted at a single center, which may limit generalizability.
Postoperative SII did not retain strong independent predictive value in the multivariate model.
Conclusion:
The findings highlight the need for stringent infection control and aggressive management of postoperative morbidity.
Damon B. Dixon, MD, at Phoenix Children’s Cardiology, is the author to this EndoText chapter. Dr. Dixon brings nationally recognized expertise in pediatric cardiovascular risk assessment and non?invasive vascular imaging.
