The Clinical and Economic Impact of Deep Chest Surgical Site Infections Following Coronary Artery Bypass Graft Surgery

Hollenbeak, Christopher S.; Murphy, Denise; Koenig, Stephanie; Woodward, Robert S.; Dunagan, W. Claiborne; Fraser, Victoria J.

doi:10.1378/chest.118.2.397

Cited by 241 publications

(221 citation statements)

References 22 publications

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“…Mediastinitis continues to be one of the main complications of cardiovascular surgery, and it is associated to high morbidity and cost [12]. The economic impact of this entity has been evaluated in several studies, most of which were conducted in the United States [12].…”

Section: Discussionmentioning

confidence: 99%

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

Sá¹,

Silva

Lima³

et al. 2010

Rev Bras Cir Cardiovasc

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Results: On average, complication occurred within 13 days after operation; in a total of 25 lethal cases (2.4%), deaths occurred in eight (32%). Several risk factors for mediastinitis were identified as follows: 56% diabetes, 56% smoking, 20% obesity, 16% chronic obstructive pulmonary disease, and 8% end-stage renal disease. Mediastinitis was reported in 21 (84%) patients submitted to coronary artery bypass grafting and it was related to a major risk for development of infection (IC 3.44-8.30, P=0.0001). High rates of complications were observed: respiratory failure (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%), and sternal dehiscence (48%). Bacterial cultures of exudates were positive in 84% of patients; Staphylococcus aureus was the most frequently pathogen (28.8%) detected.Conclusion: Mediastinitis remains as a severe surgical complication and difficult to manage in postoperative cardiovascular surgery. The disease has low incidence rate but high lethality. Coronary bypass was associated to a major risk for development of infection.Descriptors: Infection. Mediastinitis. Cardiac surgical procedures.

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Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Sá¹,

Silva

Lima³

et al. 2010

Rev Bras Cir Cardiovasc

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“…These procedures subject patients to additional risks and significant health care costs. 2,3 Although several diagnostic strategies have been evaluated, none reliably identified patients with mediastinitis.…”

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confidence: 99%

Staphylococcus aureus Bacteremia After Median Sternotomy

et al. 2003

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Background-Mediastinitis is a complication of coronary artery bypass graft surgery (CABG) that can be difficult to diagnose. This study evaluated the utility of blood culture results in identifying patients with mediastinitis. Methods and Results-All unique patients undergoing CABG at our institution over a 60-month study period (nϭ5500) and all blood cultures performed on these patients Յ90 days after CABG were identified.

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“…Which cause mortality of nearly 25%. Furthermore sternal wound infection 25% and deep sternal wound infection 33% with a composite morbidity rate of 13.4% were diagnosed between 30 to 90 days after surgery [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

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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The Clinical and Economic Impact of Deep Chest Surgical Site Infections Following Coronary Artery Bypass Graft Surgery

Cited by 241 publications

References 22 publications

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

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

Staphylococcus aureus Bacteremia After Median Sternotomy

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

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