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Preditores de infec??o no pós-operatório de cirurgia de revasculariza??o miocárdicaDOI: 10.1590/S0102-76382011000200008 Keywords: diabetes mellitus, myocardial revascularization, infection, risk. Abstract: background: although coronary artery bypass grafting (cabg) is a good alternative therapy in severe arterial disease, it may evolve with complications, especially infections. objectives: to determine the incidence of infection in post-cabg and its clinical predictors in a cardiology reference center in brazil. methods: cohort study. data were collected from all patients undergoing cabg between january/2004 and february/2006, excluding emergency surgery, absent record of glucose blood levels preoperatively and infection prior to surgery. statistical analysis: student's t test, chi square, logistic regression. results: we evaluated 717 patients, 61.9 ± 11 years old, 67.1% were men, 29.6% with diabetes, of whom 137 (19.1%) developed infection (62% respiratory, 25% superficial wound, 9.5% urinary, 3.6% deep wound). diabetes was more prevalent in those who developed infection, as well as prolonged time of indwelling central venous catheter (79.3 ± 40.5 vs. 61.0 ± 19.3 hours, p<0.001). after multivariate analysis (model adjusted for dyslipidemia, hypertension, smoking and leukocytes), both diabetes (or 4.18 [2.60-6.74]), prolonged central venous line (or 1.019 [1.00-1.02] and cardiac catheterism (or 2.03 [1.14-3.60] remained predictors of infection. while diabetes is associated with a higher percentage of infections (p <0.001), preoperative serum glucose was not associated with increased risk of infection. conclusions: diabetes and permanence of central venous catheters were associated with development of infection in post-cabg. the preoperative blood glucose was not a predictor of risk of infection. it is probably necessary to study with greater detail glycemic control trans- and post-operatively.
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