Wound Infections in Adult Patients after Berlin Heart® EXCOR Biventricular Assist Device Implantation
Abstract
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Definitions
2.2. Statistics
3. Results
3.1. Patient Characteristics
3.2. Overall Clinical Outcome after BiVAD Implantation
3.3. Infections Post-BiVAD
3.3.1. ISHLT Criteria
3.3.2. CDC Classification
3.4. Wound Infections Post-HTx
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | With Wound Infection (n = 31) | Without Wound Infection (n = 27) | p-Value |
---|---|---|---|
Age years | 47 (34–55) | 49 (34–53) | 0.668 |
Male sex | 28 (90.3%) | 20 (74.1%) | 0.105 |
Body mass index, kg/m2 | 26.9 (21.3–30.9) | 27.0 (22.4–33.2) | 0.725 |
Body surface area, m2 | 2.02 (1.85–2.2) | 1.97 (1.77–2.08) | 0.171 |
Time of BiVAD | 0.027 | ||
2006–2014 | 14 (45.2%) | 20 (74.1%) | |
2015–2020 | 17 (54.8%) | 7 (25.9%) | |
INTERMACS Profile | 0.585 | ||
1 | 20 (64.5%) | 20 (74.1%) | |
2 | 8 (25.8%) | 3 (11.1%) | |
3 | 3 (9.7%) | 4 (14.8%) | |
CMP aetiology | 0.928 | ||
Non-ischemic | 21 (67.7%) | 15 (55.6%) | |
Ischemic | 6 (19.4%) | 7 (25.9%) | |
Myocarditis | 4 (12.9%) | 5 (18.5%) | |
Comorbidities | |||
Dialysis pre-BiVAD | 9 (29.0%) | 9 (33.3%) | 0.726 |
Diabetes mellitus | 10 (32.3%) | 7 (25.9%) | 0.668 |
Hyperlipidaemia | 8 (25.8) | 7 (25.9%) | 0.992 |
Arterial hypertension | 12 (38.7%) | 11 (40.7%) | 0.876 |
Pulmonary hypertension | 17 (54.8%) | 14 (51.9%) | 0.242 |
Previous cardiac surgery | 4 (12.9%) | 7 (25.9%) | 0.211 |
Pre-operative support | |||
IABP | 7 (22.6%) | 8 (29.6%) | 0.544 |
ECLS | 14 (45.2%) | 15 (55.6%) | 0.434 |
Urgency of BiVAD | 0.387 | ||
Elective | 4 (12.9%) | 2 (7.4%) | |
Urgent | 16 (51.6%) | 12 (44.4%) | |
Emergency | 7 (22.6%) | 10 (37.0%) | |
Ultima ratio/reanimation | 4 (12.9%) | 3 (11.1%) |
With Wound Infection (n = 31) | Without Wound Infection (n = 27) | p-Value | |
---|---|---|---|
Cardiopulmonary bypass time minutes | 217.70 (138–336) | 221.23 (98–494) | 0.532 |
Aortic cross-clamp time minutes | 33.97 (0–291) | 27.23 (0–215) | 0.869 |
Concomitant cardiac surgery after BiVAD implantation | 2 (6.5%) | 2 (7.4%) | 0.887 |
Gortex membrane | 23 (74.2%) | 15 (55.6%) | 0.140 |
Minimal body temperature °C | 35.23 (32–37) | 34.41 (28–36.8) | 0.084 |
Packed red blood cells units | 9.29 ± 6.43 | 10.93 ± 7.85 | 0.462 |
Fresh frozen plasma units | 5.24 ± 6.11 | 5.47 ± 5.93 | 0.842 |
Surgery time minutes | 421.32 (273–640) | 411.00 (145–980) | 0.322 |
B | SE | Wald | df | Sig. | Exp(B) | 95.0% CI for Exp(B) | ||
---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||
Time of BiVAD | 0.881 | 0.405 | 4.741 | 1 | 0.029 | 2.413 | 1.092 | 5.334 |
Gortex membrane | 1.003 | 0.469 | 4.572 | 1 | 0.033 | 2.726 | 1.087 | 6.833 |
Superficial Wound Infection (n = 13) | Deep Wound Infection (n = 18) | p-Value | |
---|---|---|---|
Polymicrobial | 4 | 12 | 0.052 |
Monomicrobial | 9 | 6 | 0.052 |
Gram-positive | 5 | 13 | 0.064 |
S. aureus | 4 | 5 | 0.859 |
Enterococcus spec. | 1 | 8 | 0.029 |
Gram-negative | 2 | 10 | 0.026 |
P. aeruginosa | 0 | 4 | 0.073 |
Candida spec. | 4 | 5 | 0.859 |
Others * | 7 | 15 | 0.079 |
Pathogen (VAD-R) | Number of Patients | Pathogen (N-VAD) | Number of Patients |
---|---|---|---|
Gram-positive | 5 | Gram-positive | 4 |
Enterococcus spec. | 1 | Enterococcus spec. | 4 |
Coagulase-negative Staphylococcus | 4 | ||
Gram-negative | 4 | Gram-negative | 14 |
P. aeruginosa | 3 | P. aeruginosa | 4 |
Candida spec. | 4 | Candida spec. | 6 |
Clostridium difficile | 7 | ||
Herpes simplex virus | 1 |
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Kremer, J.; El-Dor, A.; Rivinius, R.; Schlegel, P.; Sommer, W.; Warnecke, G.; Karck, M.; Ruhparwar, A.; Meyer, A.L. Wound Infections in Adult Patients after Berlin Heart® EXCOR Biventricular Assist Device Implantation. Life 2022, 12, 1550. https://doi.org/10.3390/life12101550
Kremer J, El-Dor A, Rivinius R, Schlegel P, Sommer W, Warnecke G, Karck M, Ruhparwar A, Meyer AL. Wound Infections in Adult Patients after Berlin Heart® EXCOR Biventricular Assist Device Implantation. Life. 2022; 12(10):1550. https://doi.org/10.3390/life12101550
Chicago/Turabian StyleKremer, Jamila, Abbas El-Dor, Rasmus Rivinius, Philipp Schlegel, Wiebke Sommer, Gregor Warnecke, Matthias Karck, Arjang Ruhparwar, and Anna L. Meyer. 2022. "Wound Infections in Adult Patients after Berlin Heart® EXCOR Biventricular Assist Device Implantation" Life 12, no. 10: 1550. https://doi.org/10.3390/life12101550
APA StyleKremer, J., El-Dor, A., Rivinius, R., Schlegel, P., Sommer, W., Warnecke, G., Karck, M., Ruhparwar, A., & Meyer, A. L. (2022). Wound Infections in Adult Patients after Berlin Heart® EXCOR Biventricular Assist Device Implantation. Life, 12(10), 1550. https://doi.org/10.3390/life12101550