English abstract
Background: Surgical site infections (SSIs) are one of the most documented
complications after Coronary Artery Bypass Grafting (CABG) surgeries. The impact
of SSIs after CABG surgeries are enormous. Research has shown that SSIs after
CABG surgeries are the main reason for increasing the length of stay, of healthcare
costs, re-admission to hospital, and death rates. Although CABG surgery has become
a standard procedure Oman since 1999, no previous studies have been done to estimate
the prevalence and outcome of SSIs.
Aim: The aims of this study are to estimate the prevalence rate of SSIs, identify
common isolated microorganism and contributing risk factors, estimate mortality rate,
case fatality rate, length of stay, readmission rate, and healthcare costs associated with
SSIs after CABG surgeries in Oman.
Method: A retrospective nested case–control design was used to identify the SSIs
prevalence rate and risk factors for adult patients (n = 596) who underwent CABG
surgeries over 2 years (2016 – 2017) in two tertiary hospitals in Oman.
Results: The SSIs prevalence rates after CABG were 17.4% and 17.5% in 2016 and
2017, respectively. The most isolated microorganisms were gram-positive bacteria
(45.2%). SSIs risk factors include: female sex (odds ratio [OR] = 3.2, p < 0.001),
diabetes (OR = 5.83, p < 0.001), overweight or obese (OR = 2.14, p < .05), and shaving
technique (using razor shaving; OR = 8.4, p < 0.001). The overall mortality rate after
CABG surgery was 4.9%, and the case fatality rate was 5.8%. SSI was associated with
a 13-day increased length of stay. The readmission rate for the cases group was 44.2%.
The extra direct healthcare costs due to SSIs were 669 Omani Rial for each infection
case.
Conclusion: SSIs is a serious post-surgical complication. Identifying the risk factors
and the impact of SSIs on the healthcare system is the foundation to prevent SSIs.
Furthermore, the results of this study can be used as a reference baseline data for future
local or national strategies to control and prevent SSIs after CABG surgeries.
