Risk factors for nosocomial infection after elective pulmonary thoracic surgery

Background The aim was to identify risk factors for the development of infection after pulmonary surgery. Methods A retrospective analysis of 440 consecutive patients operated on between August 1987 and July 1997 was conducted. Results Nosocomial infections (NIs) were observed in 122 patients (27·7 per cent): pneumonia in 75 (17·0 per cent), urinary tract infection (UTI) in 40 (9·1 per cent), surgical site infection (SSI) in 37 (8·4 per cent), nine of which were pleural empyemas (2·0 per cent), and other infections in six (1·4 per cent). The infection‐related mortality rate was 3·2 per cent (14 patients). Multivariate analysis of 21 variables revealed that the following were independent predictors for the development of NI: No operation‐related factor, such as infection, indication for surgery, extension of pulmonary resection, duration of operation or transfusion requirements, had a significant influence on the development of NI.Infection COPD † Alcoholism † Haemoglobin <10 g dl −1 ‡ Cardiac disease Diabetes †Pneumonia 0·04 0·03 0·015 n.s. n.s. UTI n.s. n.s. n.s. n.s. n.s. SSI n.s. n.s. n.s. n.s. 0·002 Empyema n.s. n.s. 0·0005 n.s. n.s. Other n.s. n.s. 0·01 n.s. n.s. Total n.s. n.s. n.s. 0·02 n.s.COPD, chronic obstructive pulmonary disease; n.s., not significant. † Four‐field χ test ‡ k f‐field χ testConclusion The results indicate that impairment of the patient's ability to respond to surgical trauma is more important for the development of postoperative infection than factors related to the operation. © 2000 British Journal of Surgery Society Ltd