Postoperati ve pneumonia surveillance after cardiothorasic surgery: Epidemiology and risk factors

The purpose of this study was to investigate the incidence and risk factors for postoperative pneumonia (POP) after cardiac and thoracic surgery in Gazi University Faculty of Medicine, Ankara. The incidence of POP was 6.87/1000 hospitalisation day. Eleven (42.3%) of 26 POP cases were ventilator-associated pneumonia (VAP) and 15 (57.7%) were non -VAP. The incidence of invasive device-related infections in patients on mechanical ventilation was 26. We analysed preoperative, operative and postoperative risk factors for development of POP. The statistically significant preoperative risk factors were renal insufficiency, central nervous system disorder and high ASA score. None of the investigated operative risk factors found to be statistically significant. The postoperative risk factors were; aspiration after surgery, insufficient postoperative breathing exercise, postoperative complications (such as renal failure), prolonged mechanical ventilation, prolonged hospitalization and delayed mobilisation. Pneumonia and non- pneumonia nosocomial infections, need for inotropic support and high ASA score were found to be statistically significant risk factors for mortality. In conclusion, prevention of aspiration and other postoperative complications, adequate postoperative breathing exercise, early mobilisation and early hospital discharge are very important factors for prevention of POP after cardiothoracic surgery. VAP is the most common postoperative infection. For this reason removing patients from mechanical ventilation as soon as possible decreases the mortality and incidence of POP.