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Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality

BACKGROUND: Sternal wound infection (SWI) is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI...

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Autores principales: Salehi Omran, Abbas, Karimi, Abbasali, Ahmadi, S Hossein, Davoodi, Setareh, Marzban, Mehrab, Movahedi, Namvar, Abbasi, Kyomars, Boroumand, Mohammad Ali, Davoodi, Saeed, Moshtaghi, Naghmeh
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2075514/
https://www.ncbi.nlm.nih.gov/pubmed/17888179
http://dx.doi.org/10.1186/1471-2334-7-112
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author Salehi Omran, Abbas
Karimi, Abbasali
Ahmadi, S Hossein
Davoodi, Setareh
Marzban, Mehrab
Movahedi, Namvar
Abbasi, Kyomars
Boroumand, Mohammad Ali
Davoodi, Saeed
Moshtaghi, Naghmeh
author_facet Salehi Omran, Abbas
Karimi, Abbasali
Ahmadi, S Hossein
Davoodi, Setareh
Marzban, Mehrab
Movahedi, Namvar
Abbasi, Kyomars
Boroumand, Mohammad Ali
Davoodi, Saeed
Moshtaghi, Naghmeh
author_sort Salehi Omran, Abbas
collection PubMed
description BACKGROUND: Sternal wound infection (SWI) is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG) at Tehran Heart Center. METHODS: This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis) was categorized according to the Oakley classification. RESULTS: In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases) and deep SWI of 0.22 percent (21 cases). Perioperative (in-hospital) mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h), and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05) in univariate analysis. In multivariate analysis, hypertension (OR = 10.7), re-exploration (OR = 13.4), and female gender (OR = 2.7) were identified as significant predictors of SWI (p < 0.05 for all). The rate of SWI was relatively similar in 3 groups of prophylactic antibiotic regimen (Cefazolin, Cefazolin + Gentamycin and Cefazolin + Amikacin: 0.5%, 0.5%, and 0.34% respectively). CONCLUSION: Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.
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spelling pubmed-20755142007-11-13 Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality Salehi Omran, Abbas Karimi, Abbasali Ahmadi, S Hossein Davoodi, Setareh Marzban, Mehrab Movahedi, Namvar Abbasi, Kyomars Boroumand, Mohammad Ali Davoodi, Saeed Moshtaghi, Naghmeh BMC Infect Dis Research Article BACKGROUND: Sternal wound infection (SWI) is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG) at Tehran Heart Center. METHODS: This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis) was categorized according to the Oakley classification. RESULTS: In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases) and deep SWI of 0.22 percent (21 cases). Perioperative (in-hospital) mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h), and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05) in univariate analysis. In multivariate analysis, hypertension (OR = 10.7), re-exploration (OR = 13.4), and female gender (OR = 2.7) were identified as significant predictors of SWI (p < 0.05 for all). The rate of SWI was relatively similar in 3 groups of prophylactic antibiotic regimen (Cefazolin, Cefazolin + Gentamycin and Cefazolin + Amikacin: 0.5%, 0.5%, and 0.34% respectively). CONCLUSION: Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation. BioMed Central 2007-09-23 /pmc/articles/PMC2075514/ /pubmed/17888179 http://dx.doi.org/10.1186/1471-2334-7-112 Text en Copyright © 2007 Omran et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Salehi Omran, Abbas
Karimi, Abbasali
Ahmadi, S Hossein
Davoodi, Setareh
Marzban, Mehrab
Movahedi, Namvar
Abbasi, Kyomars
Boroumand, Mohammad Ali
Davoodi, Saeed
Moshtaghi, Naghmeh
Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
title Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
title_full Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
title_fullStr Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
title_full_unstemmed Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
title_short Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
title_sort superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (cabg): incidence, risk factors and mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2075514/
https://www.ncbi.nlm.nih.gov/pubmed/17888179
http://dx.doi.org/10.1186/1471-2334-7-112
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