Farinas et al identified risk factors for nosocomial infection and mortality following prosthetic vascular graft surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from Hospital Universitario Marques de Valdecilla and the University of Cantabria.
Patient selection: prosthetic vascular graft to abdominal aorta or peripheral artery
Outcome: nosocomial infection (graft infection, urinary tract infection, respiratory tract infection)
Risk factors for nosocomial infection:
(1) active lower extremity skin and soft tissue infection (SSTI) at the time of surgery (aOR 12.6 for abdominal aortic graft; aOR 2.4 for peripheral vascular graft)
(2) mechanical ventilation if abdominal aortic graft surgery (aOR 56)
(3) anemia on admission if peripheral vascular graft surgery (aOR 0.84 for hemoglobin)
(4) emergency surgery if peripheral vascular graft surgery (aOR 4.4)
Risk factors for 30-day mortality:
(1) active lower extremity SSTI (aOR 12.1)
(2) high post-surgical glucose concentration (aOR 1.02)
(3) noninfectious surgical complication (aOR 19.4)
Risk factors for long-term mortality:
(1) advanced age (RR 1.08)
(2) elevated serum creatinine at discharge (RR 1.9)
(3) surgical site infection (RR 6.4)
