The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care
- Author(s)
- Cheuk, N; Worth, LJ; Tatoulis, J; Skillington, P; Kyi, M; Fourlanos, S;
- Journal Title
- Journal of Hospital Infection
- Publication Type
- Research article
- Abstract
- BACKGROUND: 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. AIM: 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. METHODS: 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. FINDINGS: 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. CONCLUSION: 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.
- Keywords
- Antibiotic Prophylaxis; Coronary Artery Bypass/adverse effects; *Diabetes Mellitus, Type 2/complications; Humans; Retrospective Studies; Risk Factors; Sternum; *Surgical Wound Infection/epidemiology; Bypass; Coronary; Diabetes; Graft; Infection; Surgery
- Department(s)
- Infectious Diseases
- PubMed ID
- 34332004
- Publisher's Version
- https://doi.org/10.1016/j.jhin.2021.07.009
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-06-20 08:03:19
Last Modified: 2025-06-20 08:04:25