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.