Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery

Lu, John C.Y.; Grayson, Antony D.; Jha, Pankaj K.; Srinivasan, Arun K.; Fabri, Brian M.

doi:10.1016/s1010-7940(03)00137-4

Cited by 250 publications

(180 citation statements)

References 23 publications

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“…According to the literature, the incidence of DSWI after cardiac surgery has been variously reported as between 0.8 and 5.0% [1][2][3][4][5][6][7]. This postoperative complication is a serious one, being responsible for a mortality rate varies between 19% and 29% in different series of adult cardiac surgical patients [1][2][3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…This postoperative complication is a serious one, being responsible for a mortality rate varies between 19% and 29% in different series of adult cardiac surgical patients [1][2][3][4][5][6][7]. Based on JACVSD registered data from 2004 to 2009, the overall incidence of DSWI after cardiac surgery was 1.8%, as for each operative procedure, the incidence of postoperative DSWI was 1.8% in isolated CABG group, 1.3% in valve group, 2.8% in valve with CABG group, 1.9% in thoracic aorta group and 3.4% in thoracic aorta with CABG group.…”

Section: Discussionmentioning

confidence: 99%

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Deep Sternal Wound Infection After Cardiac Surgery

Kubota¹,

Ohura²

2018

Recent Clinical Techniques, Results, and Research in Wounds

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Background: Deep sternal wound infection (DSWI) is a serious postoperative complication of cardiac surgery. In this study we investigated the incidence of DSWI and effect of re-exploration for bleeding on DSWI mortality. Methods: We reviewed 73,700 cases registered in the Japan Adult Cardiovascular Surgery Database (JACVSD) during the period from 2004 to 2009 and divided them into five groups: 26,597 of isolated coronary artery bypass graft (CABG) cases, 23,136 valvular surgery cases, 17,441 thoracic aortic surgery cases, 4,726 valvular surgery plus CABG cases, and 1,800 thoracic aortic surgery plus CABG cases. We calculated the overall incidence of postoperative DSWI, incidence of postoperative DSWI according to operative procedure, 30-day mortality and operative mortality of postoperative DSWI cases according to operative procedure, 30-day mortality and operative mortality of postoperative DSWI according to whether re-exploration for bleeding, and the intervals between the operation and deaths according to whether re-exploration for bleeding were investigated. Operative mortality is defined as inhospital or 30-day mortality. Risk factors for DSWI were also examined. Results: The overall incidence of postoperative DSWI was 1.8%. The incidence of postoperative DSWI was 1.8% after isolated CABG, 1.3% after valve surgery, 2.8% after valve surgery plus CABG, 1.9% after thoracic aortic surgery, and 3.4% after thoracic aortic surgery plus CABG. The 30-day and operative mortality in patients with DSWI was higher after more complicated operative procedures. The incidence of re-exploration for bleeding in DSWI cases was 11.1%. The overall 30-day/operative mortality after DSWI with re-exploration for bleeding was 23.0%/48.0%, and it was significantly higher than in the absence of re-exploration for bleeding (8.1%/22.0%). The difference between the intervals between the operation and death according to whether re-exploration for bleeding had been performed was not significant. Age and cardiogenic shock were significant risk factors related to re-exploration for bleeding, and diabetes control was a significant risk factor related to DSWI for all surgical groups. Previous CABG was a significant risk factor related to both re-exploration for bleeding and DSWI for all surgical groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Deep Sternal Wound Infection After Cardiac Surgery

Kubota¹,

Ohura²

2018

Recent Clinical Techniques, Results, and Research in Wounds

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“…vs. 0.7%). Lu JC, et al [21] established that 30 day mortality rate was higher for all patients without WI group as compared to WI group (25.5%. vs. 2.5%).…”

Section: Discussionmentioning

confidence: 97%

Incidence and Predictor of Post-Operative Wound Infection in Patients Underwent Coronary Artery Bypass Grafting

Gull¹,

Hussain²,

Farogh³

et al. 2018

JCTCD

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Objective: To determine the incidence and predictor of postoperative wound infection in patients underwent coronary artery bypass grafting (CPB). Methods:This was a prospective comparative study of 577 patients who underwent cardiac surgery with (CPB) was conducted at cardiac surgery department of Punjab Institute of cardiology, Lahore from 1st March 2012 to 31st March 2017. Consecutive patients undergoing elective and isolated CABG, both genders age ≥20 years, with normal ejection fraction were included in the study Results: Out of 577 patients of which 166(87.83%) were male while 23(12.16%) were female. The mean age of the patient was 53.23 ± 8.43. Incidence of post-operative wound infection in patients underwent coronary artery bypass grafting (CPB) was 73(12.65%). Common co morbid conditions were hypertension 50%, diabetes mellitus (43.5%), smoking (31.1%), hyperlipidemia (20.3%), prior of stoke (12.2%), Prior Surgery (6.8%) and prior renal failure (4.1%), mean CPB time (61.69 ± 32.27), ICU stay 976.03 ± 31.93), mean Cross clamp time(25.27 ± 19.17mg/dl) and Hospital stay (10.16 ± 5.6 day) were more in WI group. Themortality was found to be high in WI group (23.3%). Logistic regression showed that significantly predicted of the post-operative WI were elder age,diabetes mellitus, smoking, family history of IHD, hyperlipidemia, cardiopulmonary bypass time, ICU stay, hospital stay. Conclusion:We can conclude that wound infected patients are at significantly greater risk of incidence, morbidity and mortality after cardiac surgery.

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“…3) Advanced age, male gender, NYHA (New York Heart Association) class ≥3, left main coronary stenosis, bilateral internal mammary artery harvesting, body mass index over 30 kg/m 2 , chronic obstructive pulmonary disease, smoking, diabetes mellitus, prolonged mechanical ventilation, re-exploration due to bleeding and massive blood transfusion are found to be the independent risk factors for mediastinitis. [4][5][6] Bone wax is a mixture of beeswax, paraffin wax and isopropyl palmitate which is used to control injured bone surface bleeding. It is used to reduce the bleeding on sternal sides in cardiac surgery providing bloodless surgical exposure with resultant lesser requirement for blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Bone Wax to Reduce Sternal Bleeding Following Coronary Bypass Surgery

Özdemir

Aykut

2014

Ann Thorac Cardiovasc Surg

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Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery

Abstract: In conclusion, we have identified risk factors for sternal wound infection, many of which are modifiable. We have also shown that there is a significant increase in mortality in patients with sternal wound infection during a 4-year follow-up period after CABG.

Cited by 250 publications

References 23 publications

Deep Sternal Wound Infection After Cardiac Surgery

Deep Sternal Wound Infection After Cardiac Surgery

Incidence and Predictor of Post-Operative Wound Infection in Patients Underwent Coronary Artery Bypass Grafting

Efficacy and Safety of Bone Wax to Reduce Sternal Bleeding Following Coronary Bypass Surgery

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