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Sazonalidade de infecções espiratórias e complicações de esternotomia pós-cirurgia cardíaca
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Introdução: As infecções respiratórias e complicações de esternotomia são complicações comuns da cirurgia cardíaca. Não está estabelecida a variação sazonal na sua incidência nem a eficácia da cinesioterapia respiratória pré-operatória na prevenção das infecções respiratórias. O objectivo deste trabalho é estudar a sazonalidade da incidência de infecções respiratórias e de esternotomia após cirurgia cardíaca, bem como a eficácia da cinesioterapia respiratória pré-operatória na prevenção das primeiras.
Métodos: Estudo retrospectivo de todos os doentes submetidos a cirurgia cardíaca por esternotomia mediana no Serviço de Cirurgia Cardiotorácica do Hospital de Santa Maria desde 1 Janeiro de 2014 a 31 de Dezembro 2014. Informação obtida através da consulta de processos clínicos.
Resultados: Entre os 854 doentes analisados, houve um total de 84 infecções respiratórias (9,84%) e 30 infecções de esternotomia (3,51%). As infecções de esternotomia demonstraram ser mais frequentes de Junho a Setembro do que de Janeiro a Abril (p=0,01). As infecções respiratórias foram mais frequentes de Fevereiro a Abril do que no período de Maio a Julho (p=0,02). Como factores de risco estatisticamente significativos foram identifcados a Doença Pulmonar Crónica para infecções respiratórias (p=0,007); revisão de hemostase (p=0,046) e utilização bilateral das artérias mamárias internas (p=0,0034) para infecções de ferida operatória.
Conclusão: O estudo identificou um padrão sazonal na incidência de infecções respiratórias e de esternotomia. As infecções respiratórias foram mais frequentes nos meses de Fevereiro a Abril e as infecções de esternotomia mais frequentes entre Junho e Setembro. Nenhum dos factores de risco para infecção pós-operatória mostrou significativa variação sazonal.
Background: Respiratory tract infections and sternal wound infections are common complications following cardiac surgery. No seasonal pattern is established for the incidence of these complications nor is the efficacy of pre-operative chest physical therapy on the prevention of respiratory tract infections. The aim of this study was to determine the influence of season variation on the incidence respiratory tract infections and sternal wound infections following cardiac surgery and the role of pre-operative chest physical therapy as a preventive measure for respiratory tract infections. Methods: Retrospectively collected data from all cardiac surgery patients undergoing operations with median sternotomy at Hospital de Santa Maria between January 2014 and December 2014. Patients’ data were acquired through medical records. Results: Of the 854 patients that were analyzed, 84 (9,84%) respiratory tract infections and 30 (3,51%) sternal wound were reported. Respiratory tract infections were more frequent from February to May (p=0,02) and sternal wound infections showed higher rates from June to September (p=0,01). As statistically significant risk factors for infections our study identified chronic pulmonary disease in regard to respiratory tract infections and hemostasis revision and bilateral use of the internal mammary artery in regard to sternal wound infections. Conclusions: This study identified a seasonal pattern in the incidence of respiratory tract infections and sternal wound infections. Respiratory tract infections were more frequent from February to May and sternal wound infections showed higher rates from June to September. None of the identified risk factors for post-operative infection showed a seasonal variation.
Background: Respiratory tract infections and sternal wound infections are common complications following cardiac surgery. No seasonal pattern is established for the incidence of these complications nor is the efficacy of pre-operative chest physical therapy on the prevention of respiratory tract infections. The aim of this study was to determine the influence of season variation on the incidence respiratory tract infections and sternal wound infections following cardiac surgery and the role of pre-operative chest physical therapy as a preventive measure for respiratory tract infections. Methods: Retrospectively collected data from all cardiac surgery patients undergoing operations with median sternotomy at Hospital de Santa Maria between January 2014 and December 2014. Patients’ data were acquired through medical records. Results: Of the 854 patients that were analyzed, 84 (9,84%) respiratory tract infections and 30 (3,51%) sternal wound were reported. Respiratory tract infections were more frequent from February to May (p=0,02) and sternal wound infections showed higher rates from June to September (p=0,01). As statistically significant risk factors for infections our study identified chronic pulmonary disease in regard to respiratory tract infections and hemostasis revision and bilateral use of the internal mammary artery in regard to sternal wound infections. Conclusions: This study identified a seasonal pattern in the incidence of respiratory tract infections and sternal wound infections. Respiratory tract infections were more frequent from February to May and sternal wound infections showed higher rates from June to September. None of the identified risk factors for post-operative infection showed a seasonal variation.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Infecções respiratórias Esternotomia Cirurgia cardíaca Cinesioterapia