Original articleAdult cardiacMediastinitis After Coronary Artery Bypass Grafting Risk Factors and Long-Term Survival
Section snippets
Source Population
The study was approved by the Regional Medical Ethics Committee and represents a multicenter collaboration between Rikshospitalet University Hospital, The Feiring Heart Clinic, and Oslo Heart Center. The institutions maintain the same diagnostic criteria and treatment with active and prospective epidemiologic surveillance of hospital infections. Between January 1989 and December 2000, a total of 18,532 adult patients undergoing CABG surgery were considered in our analysis. The diagnosis of
Risk Factors of Mediastinitis Using the Case-Control Design
The two groups of patients were comparable with respect to preoperative, intraoperative, and postoperative variables (Table 1). Mediastinitis occurred in 107 (0.6%) of 18,532 patients. The time between surgery and onset of symptoms was 12 (9 to 19) days. Irrigation time was 7 (1 to 24) days.
Independent risk factors of mediastinitis were pinpointed using the logistic model. Our results are summarized in Table 2. Age over 70 years had a 74% increased risk compared with younger patients, and male
Risk Factors of Mediastinitis
Multivariate analysis identified six preoperative variables as highly significant independent predictors for the development of mediastinitis. Four of these risk factors (diabetes, obesity BMI ≥ 30 kg/m2, COPD, and age) have often been associated with occurrence of mediastinitis [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. In addition we found male gender and LMS to be significantly associated with mediastinitis.
Diabetes mellitus turned out to be one of the most important predictors of mediastinitis. This
References (30)
- et al.
Risk factors for mediastinitis after cardiac surgery
Ann Thorac Surg
(2004) - et al.
J. Maxwell Chamberlain memorial paper. Sternal wound complications after isolated coronary artery bypass grafting: early and late mortality, morbidity, and cost of care
Ann Thorac Surg
(1990) - et al.
10-year follow-up of patients with and without mediastinitis
Semin Thorac Cardiovasc Surg
(2004) - et al.
The impact of deep sternal wound infection on long-term survival after coronary artery bypass grafting
Chest
(2005) - et al.
Mediastinitis after cardiovascular operations: a case-control study of risk factors
Ann Thorac Surg
(1998) - et al.
Mediastinitis and long-term survival after coronary artery bypass graft surgery
Ann Thorac Surg
(2000) - et al.
CDC definitions for nosocomial infections 1988
Am J Infect Control
(1988) - et al.
Postoperative mediastinitis: classification and management
Ann Thorac Surg
(1996) - et al.
The prevention and treatment of sternum separation following open heart surgery
J Thorac Cardiovasc Surg
(1977) - et al.
Sternal wound infections and use of internal mammary artery grafts
J Thorac Cardiovasc Surg
(1991)