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 Children's 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.