Titre
Influence of deep sternal wound infection on long-term survival after cardiac surgery.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Medical Science Monitor
Auteur(s)
Colombier, S.
Auteure/Auteur
Kessler, U.
Auteure/Auteur
Ferrari, E.
Auteure/Auteur
von Segesser, L.K.
Auteure/Auteur
Berdajs, D.A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1643-3750
Statut éditorial
Publié
Date de publication
2013
Volume
19
Première page
668
Dernière page/numéro d’article
673
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: epublish
Résumé
BACKGROUND: This study aimed to investigate the influence of deep sternal wound infection on long-term survival following cardiac surgery.
MATERIAL AND METHODS: In our institutional database we retrospectively evaluated medical records of 4732 adult patients who received open-heart surgery from January 1995 through December 2005. The predictive factors for DSWI were determined using logistic regression analysis. Then, each patient with deep sternal wound infection (DSWI) was matched with 2 controls without DSWI, according to the risk factors identified previously. After checking balance resulting from matching, short-term mortality was compared between groups using a paired test, and long-term survival was compared using Kaplan-Meier analysis and a Cox proportional hazard model.
RESULTS: Overall, 4732 records were analyzed. The mean age of the investigated population was 69.3±12.8 years. DSWI occurred in 74 (1.56%) patients. Significant independent predictive factors for deep sternal infections were active smoking (OR 2.19, CI95 1.35-3.53, p=0.001), obesity (OR 1.96, CI95 1.20-3.21, p=0.007), and insulin-dependent diabetes mellitus (OR 2.09, CI95 1.05-10.06, p=0.016). Mean follow-up in the matched set was 125 months, IQR 99-162. After matching, in-hospital mortality was higher in the DSWI group (8.1% vs. 2.7% p=0.03), but DSWI was not an independent predictor of long-term survival (adjusted HR 1.5, CI95 0.7-3.2, p=0.33).
CONCLUSIONS: The results presented in this report clearly show that post-sternotomy deep wound infection does not influence long-term survival in an adult general cardio-surgical patient population.
MATERIAL AND METHODS: In our institutional database we retrospectively evaluated medical records of 4732 adult patients who received open-heart surgery from January 1995 through December 2005. The predictive factors for DSWI were determined using logistic regression analysis. Then, each patient with deep sternal wound infection (DSWI) was matched with 2 controls without DSWI, according to the risk factors identified previously. After checking balance resulting from matching, short-term mortality was compared between groups using a paired test, and long-term survival was compared using Kaplan-Meier analysis and a Cox proportional hazard model.
RESULTS: Overall, 4732 records were analyzed. The mean age of the investigated population was 69.3±12.8 years. DSWI occurred in 74 (1.56%) patients. Significant independent predictive factors for deep sternal infections were active smoking (OR 2.19, CI95 1.35-3.53, p=0.001), obesity (OR 1.96, CI95 1.20-3.21, p=0.007), and insulin-dependent diabetes mellitus (OR 2.09, CI95 1.05-10.06, p=0.016). Mean follow-up in the matched set was 125 months, IQR 99-162. After matching, in-hospital mortality was higher in the DSWI group (8.1% vs. 2.7% p=0.03), but DSWI was not an independent predictor of long-term survival (adjusted HR 1.5, CI95 0.7-3.2, p=0.33).
CONCLUSIONS: The results presented in this report clearly show that post-sternotomy deep wound infection does not influence long-term survival in an adult general cardio-surgical patient population.
PID Serval
serval:BIB_42183842A733
PMID
Date de création
2013-09-08T08:17:26.641Z
Date de création dans IRIS
2025-05-20T15:01:18Z
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BIB_42183842A733.P001.pdf
Version du manuscrit
preprint
Taille
402.61 KB
Format
Adobe PDF
PID Serval
serval:BIB_42183842A733.P001
URN
urn:nbn:ch:serval-BIB_42183842A7337
Somme de contrôle
(MD5):c06c4d02597f5d472d8b6637e2b11fd0