This bidirectional cohort included 1,222 patients undergoing cardiac surgery with cardiopulmonary bypass; postoperative infections during hospitalisation and/or later occurred in 17.3%. Compared with uninfected patients, those with infection had higher 90-day mortality (3.8% versus 1.5%, p=0.045) and 1-year mortality (5.7% versus 2.7%, p=0.032). CRP, white blood cell count, and temperature performed poorly for infection detection, despite peak CRP and peak temperature being independent predictors. Peak temperature occurred on postoperative day 5 in infected patients versus day 2 in those without infection.
Postoperative infection was associated with higher mortality after cardiac surgery with bypass. Common inflammatory markers showed poor diagnostic performance, limiting their usefulness for distinguishing infection from postoperative inflammation.
Study limitation: The observational comparison cannot establish causality; infected patients had more comorbidities and underwent more complex procedures.
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