RESULTS
During the study period, 74 (1.3%) of 5400 consecutive cardiovascular surgery patients developed MDR-AB infection and consisted our study population. Demographic and clinical data of the patients are presented in Table 1. The mean age of the patients was 64,2 and the mean SOFA score was 11,2±3,07. The majority of undergone surgical procedures were 32 coronary artery bypass, 12 coronary artery bypass + valve surgery, 11 bivalvular surgery, and 13 aortic surgery. The lower respiratory tract was the most frequent site (78.4 %) of MDR-AB isolation and followed by surgical site (10.8 %). Colistin was the most active antimicrobial agent. Univariate analysis for mortality is presented in Table 2. None of the preoperative existing comorbidities was affecting mortality except hypertension, which is found protective. In hypertensive group mortality rate was 61.5% whereas in non-hypertensive group was 85.4% (p:0.022). In logistic regression analyse SOFA score, acute renal failure, mechanical ventilation duration, coagulopathy, hypoalbuminemia, inotropic support, acidosis, intensive care hospitalization, elevated glucose value, low lymphocyte count appear as predictors of the mortality.
Mortality rate was 77% with 57 patients. SOFA score was significantly higher in mortal group 11,54±2,9 vs 9,41±1,9 (p: 0.008). Beside SOFA score low output syndrome, renal replacement therapy requirement, hypoalbuminemia, coagulopathy, hepatic insufficiency, cerebral dysfunction and hyperbilirubinemia were statistically significant predictors for mortality. İn addition, inotrop usage was higher comparing to the survival group. In these patients with significantly lower calculated lymphocyte counts, the association of low lymphocyte levels detected in follow-up with mortality. This may be a poor prognostic factor. While the mean of glucose in the mortal group was high, it was not statistically significant. Whereas acidosis was more common in the mortal group.