Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery

Aim. To study the prevalence and risk factors (RF) for hospital-acquired pneumonia (HAP) after on-pump cardiac surgery in a modern cohort of patients.Material and methods. This retrospective analysis of the medical records of cardiovascular surgery patients, operated on in the period from January 1,...

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Main Authors: T. P. Kalashnikova, Yu. K. Podoksenov, N. O. Kamenshchikov, Yu. A. Arsenyeva, M. B. Gorchakova, I. V. Kravchenko, M. S. Kozulin, E. T. Romanyuk, S. A. Kunitsin, B. N. Kozlov, A. A. Boshchenko
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2025-01-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/6094
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author T. P. Kalashnikova
Yu. K. Podoksenov
N. O. Kamenshchikov
Yu. A. Arsenyeva
M. B. Gorchakova
I. V. Kravchenko
M. S. Kozulin
E. T. Romanyuk
S. A. Kunitsin
B. N. Kozlov
A. A. Boshchenko
author_facet T. P. Kalashnikova
Yu. K. Podoksenov
N. O. Kamenshchikov
Yu. A. Arsenyeva
M. B. Gorchakova
I. V. Kravchenko
M. S. Kozulin
E. T. Romanyuk
S. A. Kunitsin
B. N. Kozlov
A. A. Boshchenko
author_sort T. P. Kalashnikova
collection DOAJ
description Aim. To study the prevalence and risk factors (RF) for hospital-acquired pneumonia (HAP) after on-pump cardiac surgery in a modern cohort of patients.Material and methods. This retrospective analysis of the medical records of cardiovascular surgery patients, operated on in the period from January 1, 2022 to December 31, 2022. The study consistently included 417 patients who underwent on-pump cardiac surgery. The incidence and timing of HAP development were assessed. The influence of the main demographic, clinical, and perioperative factors on HAP risk was studied.Results. The pneumonia prevalence per year was 27,6%, including after the Frozen Elephant Trunk (FET) procedure — 32%, after coronary artery bypass grafting (CABG) — 29,5%, after combined CABG and heart valve surgery — 26,2%, after isolated valve surgery — 25,9%, after thoracic aortic hemiarch replacement — 19,5%. Pneumonia developed on the 4,6±2,9 day after surgery. The risk of pneumonia increased with atrial fibrillation (AF) before surgery (odds ratio (OR) 3,17; 95% confidence interval (CI): 1,67; 6,02, p=0,0002), on-pump duration (OR 1,01; 95% CI: 1,00; 1,01; p=0,0006), aortic cross-clamping (OR 1,01; 95% CI: 1,00; 1,01; p=0,0002) and mechanical ventilation (OR 1,03; 95% CI: 1,01; 1,05; p=0,005). Pneumonia predictors were on-pump duration ≥96 min (sensitivity 67,7%, specificity 64,6%, AUC=0,681, p=0,0006) and mechanical ventilation ≥14 h (sensitivity 63,1%, specificity 69,3%, AUC=0,641, p=0,005), as well as preoperative AF (sensitivity 61%, specificity 75%, p=0,0002).Conclusion. Preoperative AF, on-pump duration ≥96 min and mechanical ventilation ≥14 h serve as categorical and quantitative predictors of postoperative HAP in a modern cohort of patients.
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spelling doaj-art-b91f754015ac45f8a5859581790e49e42025-08-20T03:21:19Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202025-01-01291210.15829/1560-4071-2024-60944264Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgeryT. P. Kalashnikova0Yu. K. Podoksenov1N. O. Kamenshchikov2Yu. A. Arsenyeva3M. B. Gorchakova4I. V. Kravchenko5M. S. Kozulin6E. T. Romanyuk7S. A. Kunitsin8B. N. Kozlov9A. A. Boshchenko10Cardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterAim. To study the prevalence and risk factors (RF) for hospital-acquired pneumonia (HAP) after on-pump cardiac surgery in a modern cohort of patients.Material and methods. This retrospective analysis of the medical records of cardiovascular surgery patients, operated on in the period from January 1, 2022 to December 31, 2022. The study consistently included 417 patients who underwent on-pump cardiac surgery. The incidence and timing of HAP development were assessed. The influence of the main demographic, clinical, and perioperative factors on HAP risk was studied.Results. The pneumonia prevalence per year was 27,6%, including after the Frozen Elephant Trunk (FET) procedure — 32%, after coronary artery bypass grafting (CABG) — 29,5%, after combined CABG and heart valve surgery — 26,2%, after isolated valve surgery — 25,9%, after thoracic aortic hemiarch replacement — 19,5%. Pneumonia developed on the 4,6±2,9 day after surgery. The risk of pneumonia increased with atrial fibrillation (AF) before surgery (odds ratio (OR) 3,17; 95% confidence interval (CI): 1,67; 6,02, p=0,0002), on-pump duration (OR 1,01; 95% CI: 1,00; 1,01; p=0,0006), aortic cross-clamping (OR 1,01; 95% CI: 1,00; 1,01; p=0,0002) and mechanical ventilation (OR 1,03; 95% CI: 1,01; 1,05; p=0,005). Pneumonia predictors were on-pump duration ≥96 min (sensitivity 67,7%, specificity 64,6%, AUC=0,681, p=0,0006) and mechanical ventilation ≥14 h (sensitivity 63,1%, specificity 69,3%, AUC=0,641, p=0,005), as well as preoperative AF (sensitivity 61%, specificity 75%, p=0,0002).Conclusion. Preoperative AF, on-pump duration ≥96 min and mechanical ventilation ≥14 h serve as categorical and quantitative predictors of postoperative HAP in a modern cohort of patients.https://russjcardiol.elpub.ru/jour/article/view/6094hospital-acquired pneumoniarisk factorsartificial circulationaortic cross-clampingartificial pulmonary ventilationatrial fibrillation
spellingShingle T. P. Kalashnikova
Yu. K. Podoksenov
N. O. Kamenshchikov
Yu. A. Arsenyeva
M. B. Gorchakova
I. V. Kravchenko
M. S. Kozulin
E. T. Romanyuk
S. A. Kunitsin
B. N. Kozlov
A. A. Boshchenko
Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery
Российский кардиологический журнал
hospital-acquired pneumonia
risk factors
artificial circulation
aortic cross-clamping
artificial pulmonary ventilation
atrial fibrillation
title Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery
title_full Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery
title_fullStr Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery
title_full_unstemmed Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery
title_short Prevalence and risk factors for hospital-acquired pneumonia after on-pump cardiac surgery
title_sort prevalence and risk factors for hospital acquired pneumonia after on pump cardiac surgery
topic hospital-acquired pneumonia
risk factors
artificial circulation
aortic cross-clamping
artificial pulmonary ventilation
atrial fibrillation
url https://russjcardiol.elpub.ru/jour/article/view/6094
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