Risk factors for mediastinitis after cardiac surgery – a retrospective analysis of 1700 patients

Abstract

Background: Mediastinitis is a rare, but serious complication of cardiac surgery. It has a significant socioeconomic impact and high morbidity. The purpose of this study was to determine pre-, intra-, and postoperative predictors of mediastinitis.

Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas

“…Another important aspect was the presence of the Acinetobacter spp in 20% (n=5) of cases. Diez et al [13] and Souza et al [17] analyzing the etiologic agents involved in the appearance of mediastinitis in the post-operative of cardiovascular surgery through culture media from the surgical wound did not obtain any incidence of Acinetobacter spp among their cases. On the other hand, they have found agents not observed in our cases such as Escherichia coli and Pseudomonas aeruginosa.…”

“…The economic impact of this entity has been evaluated in several studies, most of which were conducted in the United States [12]. Diez et al [13] have found that the mean length of stay was 45 days, demonstrating the morbidity degree that the disease impinges to the patient. Our data have also shown a significantly prolonged mean length of stay (56.4 days)…”

Risk factors for mediastinitis after coronary artery bypass grafting surgery

“…They also suggest that skin preparation can be difficult and inappropriate because the deep folds of the skin and fatty tissue itself, which can act as a substrate for infection. Diez et al [15] related the etiology of mediastinitis in obese patients with bradytrophic properties of adipose tissue that contribute to poor healing of wounds.…”

Diabéticos devem ter a artéria torácica interna esqueletizada? Avaliação da perfusão esternal por cintilografia

“…A retrospective study, analyzing a series of 2,594 patients undergoing CABG, showed, among other factors, the use of ITAs as a major risk factor for sternal infection [9]. A prospective, non-randomized study, in a series of 2,356 patients, identified through multivariate analysis, as a risk factor for sternal infection, the use of ITAs in the presence of diabetes mellitus [7].…”

“…However, this technique is not yet performed as a current practice, by arguing that the use of ITA would be associated with more morbidity, increased need for hemotransfusion [5], increasing probability of transoperative myocardial infarction [6] and, in particular, sternal osteomyelitis [7][8][9][10].…”