Volume 26, Number 10—October 2020
Dispatch
Polyester Vascular Graft Material and Risk for Intracavitary Thoracic Vascular Graft Infection1
Table
Risk for early and late intracavitary thoracic PVGI among cardiac surgery patients with vascular woven polyester grafts coated with collagen or gelatin, Zurich, Switzerland*
| Demographics and risk factors | Early thoracic PVGI, n = 15 | Late thoracic PVGI, n = 13 | Cardiac surgery, no PVGI, n = 384 | p value† |
|---|---|---|---|---|
| Demographic | ||||
| Sex | 0.27 | |||
| M | 3 (20) | 3 (23) | 54 (14) | |
| F | 12 (80) | 10 (77) | 330 (86) | |
| Caucasian race | 15 (100) | 12 (92) | 375 (98) | 0.51 |
| Age, y, median (IQR) |
65 (54–68) |
65 (51–68) |
58 (49–67) |
0.89 |
| Risk factors | ||||
| BMI, kg/m2, median (IQR) | 27 (24–33) | 26 (23–28) | 26 (24–29) | 0.97 |
| Smoking | 0.69 | |||
| Never | 6 (40) | 6 (46) | 150 (39) | |
| Former/current | 9 (60) | 7 (54) | 234 (61) | |
| Alcohol consumption | 4 (27) | 3 (23) | 131 (34.0) | 0.41 |
| Hypertension | 12 (80) | 8 (62) | 273 (72) | 1.0 |
| Diabetes mellitus | 2 (13) | 1 (8) | 54 (14) | 0.78 |
| Dyslipidemia | 7 (47) | 6 (46) | 196 (51) | 0.70 |
| Cardiac events | 8 (53) | 7 (54) | 173 (45) | 0.43 |
| Cerebrovascular events | 3 (20) | 3 (23) | 58 (15) | 0.41 |
| Coagulopathy | 0 (0) | 0 (0) | 4 (1.0) | 1.0 |
| Malignancy, | 4 (27) | 2 (15) | 69 (18) | 0.62 |
| Charlson Comorbidity Index score, median (IQR) |
2 (1–5) |
2 (1–4) |
1 (1–3) |
0.27 |
| Index surgery | 0.55 | |||
| Dissection | 7 (57) | 6 (46) | 154 (40) | |
| Aneurysm/pseudoaneurysm | 8 (53) | 7 (54) | 230 (60) | |
| Symptoms at index operation | 0.004 | |||
| Asymptomatic | 4 (27) | 5 (23) | 223 (58) | |
| Symptomatic | 9 (60) | 10 (77) | 161 (42) | |
| Setting of index operation | 0.08 | |||
| Elective | 9 (60) | 7 (54) | 284 (74) | |
| Urgent/emergency | 6 (40) | 6 (46) | 100 (26) | |
| ASA class at index operation | <0.001 | |||
| Grade <III | 7 (47) | 3 (23) | 38 (10) | |
| Grade >III | 8 (53) | 10 (77) | 346 (90) | |
| Cardiopulmonary bypass time, min, median (IQR) | 174 (154–338) | 163 (84–363) | 206 (154–338) | 0.23 |
| Polyester vascular woven grafts | 0.005 | |||
| Collagen graft | 11 (74) | 9 (69) | 165 (39.5) | |
| Gelatin graft |
4 (27) |
4 (31) |
219 (52.4) |
|
| PVGI | ||||
| Assumed route | NA | |||
| Perioperative | 15 (100) | 0 | NA | |
| Hematogenous | 0 | 8 (62) | NA | |
| Contiguous | 0 | 5 (38) | NA | |
| Microorganisms | NA | |||
| Staphylococcus aureus | 4 (27) | 3 (23) | NA | |
| Coagulase-negative staphylococci | 2 (13) | 1 (7.7) | NA | |
| Enterococcus faecalis | 0 | 2 (15) | ||
| Streptococcus spp | 4 (27) | 0 | NA | |
| Cutibacterium acnes | 1 (7) | 2 (15) | NA | |
| Pseudomonas aeruginosa | 1 (7) | 0 | NA | |
| Pasteurella multocida | 1 (7) | 0 | NA | |
| Culture negative | 2 (14) | 3 (23) | NA |
*Values are no. (%) unless otherwise indicated. ASA, American Society of Anesthesiology; BMI, body mass index; IQR, interquartile range; NA, not applicable; PVGI, prosthetic vascular graft infection.
†p values from Fisher exact test (categorical variables) and Wilcoxon rank-sum test (continuous variables) comparing patients with PVGI (early and late combined) and patients without PVGI.
1This work was presented in part at the Joint Meeting Club de Pathologie Infectieuse and Swiss Society of Microbiology Meeting, Bern, Switzerland, 2019 Feb 6; and at the International Society of Cardiovascular Infectious Diseases Symposium, Lausanne, Switzerland, 2019 Jun 2–4.
2These senior authors contributed equally to this article.