THE ROLE OF RISK FACTORS IN THE DEVELOPMENT OF NOSOCOMIAL INFECTION AFTER CARDIAC SURGERY

Prevention of nosocomial infections in the postoperative period based on an assessment of the risks of their development in cardiac surgery patients is an important task from an economic point of view, which is also important for ensuring life expectancy and improving its quality in people with diseases of the cardiovascular system. The assessment of the risk of infectious complications in cardiac surgery patients is an urgent topic, which is reflected in the growing number of original articles and reviews published both in the domestic and foreign press. A literary search was conducted for the results of original research and reviews on databases Embase.com, PubMed, Research Gate, eLibrary. Based on the results of the analytical review, it was concluded that it is necessary to evaluate a set of parameters that have a synergistic effect on the risk of nosocomial infection in patients with cardiac surgery. The most significant preoperative risk factors may include age over 60 years, body mass index over 24 kg/m2, smoking, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, high-grade chronic heart failure, peripheral vascular disease, previous history of heart surgery. Immediately upon admission, the likelihood of developing IBI may be affected by severe preoperative hypoalbuminemia and anemia, low hematocrit, and a high serum creatinine level. During surgery, cardiopulmonary bypass time more than 120 minutes, intraoperative blood loss, and blood transfusion may be risk factors for the development of IBI. During surgery, as the risk factors for the development of nosocomial infections cardiopulmonary bypass time of more than 120 minutes, intraoperative blood loss of more than 2000 ml, and infusion of large volumes of blood-substituting fluids might be  considered. Artificial intelligence can be used to develop a scale for assessing risk in the future. The role of the pathobiome and the presence of foci of chronic infection in cardiac surgery patients in the development of nosocomial complications requires additional research. An endogenous source in the development of nosocomial infection may be more significant than an exogenous infection.