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J Thorac Cardiovasc Surg 2003;126:992-999
© 2003 The American Association for Thoracic Surgery

Surgery for acquired cardiovascular disease

Risk factors for leg harvest surgical site infections after coronary artery bypass graft surgery

^a Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo, USA
^b Department of Surgery, Mayo Clinic, Rochester, Minn, USA
^c Department of Surgery, Washington University School of Medicine, St Louis, Mo, USA
^d Department of Infection Control, Barnes-Jewish Hospital, St Louis, Mo, USA

Received for publication September 19, 2002; revisions received October 25, 2002; accepted for publication December 27, 2002.

^* Address for reprints: Margaret A. Olsen, MPH, PhD, Washington University School of Medicine, Division of Infectious Diseases, 660 South Euclid Ave, Campus Box 8051, St Louis, MO 63110-1093, USA
molsen{at}im.wustl.edu

OBJECTIVE: Harvest site infections are more common than chest surgical infections after coronary artery bypass surgery, yet few studies detail risk factors for these infections. We sought to determine independent risk factors for leg surgical site infections using our institutional Society of Thoracic Surgeons database.

METHODS: We retrospectively analyzed data collected from 1980 coronary artery bypass patients undergoing surgery at our institution from January 1, 1996, through June 30, 1999, using The Society of Thoracic Surgeons database. Independent risk factors for leg harvest site infection were identified by multivariate logistic regression.

RESULTS: Seventy-six patients (4.5%) were coded as having had a leg harvest site infection, of which 67 were confirmed by infection control. The length of hospital stay after surgery was significantly longer in patients with leg harvest site infection (mean 10.1 days) compared with that of patients without infection (mean 7.1 days, P < .001), and infected patients were more likely to be readmitted to the hospital within 30 days of surgery. Independent risk factors for leg harvest site infection included previous cerebrovascular accident (odds ratio, 2.9), postoperative transfusion of 5 units or more of red blood cells (odds ratio, 2.8), obesity (odds ratio, 2.5), age 75 years or older (odds ratio, 1.9), and female gender (odds ratio, 1.8).

CONCLUSIONS: Consistent with previous studies, female gender and obesity were identified as independent risk factors for leg harvest site infection, while previous cerebrovascular accident, postoperative transfusion, and older age are newly described risk factors. The Society of Thoracic Surgeons database is a useful tool for identification of predictors of leg harvest site infections.