Prevalence and Outcomes of Postoperative Infection Among Pediatric Congenital Heart Disease Patients in Intensive Care Units: A Single Center Retrospective Study

Backgroud Postoperative infections are a major complication in pediatric congenital heart disease (CHD) patients, leading to prolonged ICU stays, increased mechanical ventilation time, and extended hospitalization. This study aims to investigate the prevalence, clinical outcomes, and associated risk factors for postoperative infections in pediatric CHD patients. Methods This retrospective study included 1,131 pediatric CHD patients who underwent surgery at Xinhua Hospital Affiliated to Shanghai Jiao Tong University between October 2020 and July 2024. Patients were classified into infected (n = 131) and non-infected (n = 1000) groups. Clinical characteristics, infection status, and outcomes were analyzed. Statistical analyses were performed using Mann-Whitney U tests and logistic regression models to assess the impact of infections on hospitalization duration, ICU stay, and mechanical ventilation time. Results Infections occurred in 11.6% of patients and were independently associated with prolonged hospitalization (adjusted OR = 3.10, 95% CI: 1.84–5.20), ICU stay (aOR = 3.51, 95% CI: 2.01–6.12), and mechanical ventilation (aOR = 1.85, 95% CI: 1.09–3.11). Other independent predictors of prolonged stay included cyanotic lesions, pulmonary hypertension, and high Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery (STAT) Mortality Category. Among infected patients, multidrug-resistant organism infection (+ 11.54 days), delayed pathogen sampling (≥ postoperative day 5; +14.92 days), prematurity (+ 29.00 days), and extracardiac malformations were significantly associated with extended hospitalization. Conclusions Postoperative infections are significantly associated with prolonged hospitalization and delayed recovery in pediatric CHD patients, particularly among those with high STAT category, cyanotic heart disease, and pulmonary hypertension. Early detection and targeted infection control measures may help improve outcomes in this high-risk population. Future research should focus on multi-center prospective studies and advanced diagnostic tools to enable timely and effective infection management.