ArticleFrontiers in pediatrics2026
Evaluation of nosocomial infections after congenital heart surgery in children: a comprehensive analysis including the systemic immune-inflammation index.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Nosocomial infections (NIs) following cardiac surgery in children with congenital heart disease (CHD) remain a significant contributor to morbidity, mortality, and prolonged hospital stays. This study aimed to identify independent risk factors for NI and to evaluate the predictive utility of the Systemic Immune-Inflammation Index (SII) in this high-risk population. Material and methods: This was a single-center, retrospective observational study involving patients who underwent cardiovascular surgery between January 2015 and March 2025 and remained hospitalized for > 48 h. NI was defined based on the Center for Disease Control's National Healthcare Safety Network (CDC/NHSN) criteria. Multivariate logistic regression analysis using the 'backward conditional' method was performed to determine independent predictors of NI. Baseline and postoperative SII were calculated. Results: A total of 209 children were included in the study. NIs were observed in 46 patients (22.0%), with sepsis (69.6%) and pneumonia (30.4%) being the most frequent types. Gram-negative bacteria (58.4%) predominated. Patients with NI were significantly younger, more frequently had cyanotic CHD, comorbidities, and higher Aristotle scores. Univariate analysis showed that postoperative SII was significantly lower in the infection group (562.73 vs. 916.28; Discussion: Postoperative complications are the strongest independent predictor for NIs following pediatric cardiac surgery. Prolonged mechanical ventilation and postoperative LOS significantly increase this risk. While SII correlates with infection status negatively, it does not function as a robust independent predictor in this patient population, possibly due to the overwhelming inflammatory response induced by cardiopulmonary bypass. These findings underscore the need for stringent infection control and aggressive management of postoperative morbidity.
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