抄録
The effect and necessity of antimicrobial agents in preventing postoperative infections have been variously reported in the literature. Based on the results of these studies, prophylactic antimicrobial agents were administrated prior to operations. However, postoperative infections, major postoperative complications, can pose a serious clinical problem.
Using a retrospective analysis, the risk factors for postoperative infections were investigated in the following patients : those undergoing primary coronary artery bypass grafting on-pump (CABG : N=168) and others undergoing the same procedure off-pump (OPCAB : N=398).
To clarify the risk factors, each patient was assigned to one of the following 2 groups : those treated with cefazolin (CEZ) both before and after surgery and those who received other antibiotics instead of CEZ after surgery. The parameters recorded for each patient were as follows :
(1) Factors related to the patient : age, gender, WBC on postoperative day 3, a complication of diabetes mellitus (DM), and preoperative findings, including the total cholesterol level, uric acid level, serum albumin content, blood hemoglobin concentration, blood product use, New York Heart Association classification of cardiac patient, Ejection Fraction, and creatinine clearance (C-Cr).
(2) Factors related to the surgical procedures : the time required for surgery, aortic cross-clamping time, duration of extracorporeal circulation, variation in the use of the internal thoracic artery, duration of use of a drainage tube, and the nature of the operation (emergency or elective).
Significant variations were noted for some of these parameters. More significant differences were noted regarding the time required for surgery (on-pump CABG, OPCAB : p< 0.01), complications by DM (on-pump CABG : p<0.05, OPCAB : p<0.01) and WBC on postoperative day 3 (on-pump CABG, OPCAB : p<0.01). The Goal is to present the results of this study to physicians and recommend their incorporation into a design when developing future clinical paths.
