Long term mortality of deep sternal wound infection after coronary artery bypass surgery

Moraes, Aline; Abboud, Cely Saad; Chammas, André Zeraik Limma; Aguiar, Yara Santos; Mendes, Lucas Cronemberger Maia; Neto, Jônatas Melo; Farsky, Pedro Sílvio

doi:10.5935/1678-9741.20120065

Cited by 13 publications

(9 citation statements)

References 16 publications

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“…Mortality due to a cardiac event was not significantly different in the 2 groups investigated: 15% in DSWI and 11% in controls. This result corresponds to the reports published in which the impact of DSWI following cardiac surgery was evaluated over a period of 8 years [12,15]. Thirty-day mortality was also elevated in the DSWI group – 7.3% vs. 1.6% in the control group [15].…”

Section: Discussionsupporting

confidence: 87%

“…Information regarding mortality and complications during this period were obtained. Incidence of DSWI was 1.56%, with perioperative mortality of 8.1%; both results are comparable to results published in the literature, in which the incidence of DSWI is reported to be between 1.5% and 3%, with a perioperative mortality ranging from 15% to 30% [10–12]. Out of 74 patients, a cardiac cause of death was presented in 5 patients and sepsis was presented in 4 cases.…”

Section: Discussionsupporting

confidence: 80%

“…Although the characteristics of DSWI were well explored, long-term survival and mortality profile of the patients having DSWI after hospital admission has not been sufficiently described and evaluated. To the best of our knowledge, few reports in the literature have discussed mid-term or long-term results following DSWI [10–12]. …”

Section: Discussionmentioning

confidence: 99%

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Influence of deep sternal wound infection on long-term survival after cardiac surgery

Berdajs¹

2013

Med Sci Monit

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BackgroundThis study aimed to investigate the influence of deep sternal wound infection on long-term survival following cardiac surgery.Material/MethodsIn our institutional database we retrospectively evaluated medical records of 4732 adult patients who received open-heart surgery from January 1995 through December 2005. The predictive factors for DSWI were determined using logistic regression analysis. Then, each patient with deep sternal wound infection (DSWI) was matched with 2 controls without DSWI, according to the risk factors identified previously. After checking balance resulting from matching, short-term mortality was compared between groups using a paired test, and long-term survival was compared using Kaplan-Meier analysis and a Cox proportional hazard model.ResultsOverall, 4732 records were analyzed. The mean age of the investigated population was 69.3±12.8 years. DSWI occurred in 74 (1.56%) patients. Significant independent predictive factors for deep sternal infections were active smoking (OR 2.19, CI95 1.35–3.53, p=0.001), obesity (OR 1.96, CI95 1.20–3.21, p=0.007), and insulin-dependent diabetes mellitus (OR 2.09, CI95 1.05–10.06, p=0.016). Mean follow-up in the matched set was 125 months, IQR 99–162. After matching, in-hospital mortality was higher in the DSWI group (8.1% vs. 2.7% p=0.03), but DSWI was not an independent predictor of long-term survival (adjusted HR 1.5, CI95 0.7–3.2, p=0.33).ConclusionsThe results presented in this report clearly show that post-sternotomy deep wound infection does not influence long-term survival in an adult general cardio-surgical patient population.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 80%

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Influence of deep sternal wound infection on long-term survival after cardiac surgery

Berdajs¹

2013

Med Sci Monit

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“…Second, the infection of the sternotomy wound is a common complication after cardiac surgery, which is often associated with mediastinitis and the most protracted wound healing problems with instability of the sternum [79]. A reoperation for revision of the infected and unstable sternum is essential in such cases and not only provides an extremely stressful engagement with additional risks and pain for the patient himself but is usually directly associated with increased postoperative mortality [80]. Although sternal infections are largely reduced to a minimum following utmost care and hygiene, this burdensome and costly complication cannot be avoided in all cases [81].…”

Section: Degradable Sternal Cerclage and Release Of Active Agentmentioning

confidence: 99%

Cardiovascular Applications of Magnesium Alloys

Schilling¹,

Bauer²,

LaLonde³

et al. 2017

Magnesium Alloys

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Therapy in cardiovascular medicine often relies on implantation of prosthetic materials or application of stents. The diseases of many cardiovascular structures require their complete and immediate repair by utilising prosthetic materials. The ideal cardiovascular prosthesis involves good functional properties, capability of regeneration and does not activate the host's immune system. Ideally, the graft can be applied for a temporary use and degrades after a predefined period according to controlled degradation kinetics. Only biological grafts would provide this spectrum of properties by today's level of knowledge. However, biological prostheses exhibit some relevant drawbacks as well, such as insufficient mechanical stability or restricted availability. Implants or supporting structures of magnesium alloys would bridge this gap and would either provide a substrate for innovative and temporary grafts or would-as supporting structures-transiently add some missing properties to regenerative biological prostheses. This chapter reviews the different fields of cardiovascular therapeutic applications of magnesium alloys. The required properties of magnesium alloys and their preparation, fabrication and testing will be discussed under the specific cardiovascular perspective.

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“…4 Em estudo de caso-controle, os autores analisaram pacientes submetidos à CRVM num hospital brasileiro e identificaram que ter infecção esternal profunda ou mediastinite aumentou oito vezes o risco de óbito. 5 Na última década, mais ênfase passou a ser dada à segurança do paciente. Na área de cirurgia, os estudos têm enfocado principalmente a implementação do check list de cirurgia segura.…”

Section: Introductionunclassified

Risk factors for mediastinitis after coronary artery bypass grafting surgery: An integrative review

Silva¹,

Canini²,

Silveira³

et al. 2015

REME: Revista Mineira De Enfermagem

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Long term mortality of deep sternal wound infection after coronary artery bypass surgery

Cited by 13 publications

References 16 publications

Influence of deep sternal wound infection on long-term survival after cardiac surgery

Influence of deep sternal wound infection on long-term survival after cardiac surgery

Cardiovascular Applications of Magnesium Alloys

Risk factors for mediastinitis after coronary artery bypass grafting surgery: An integrative review

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