Risk Analysis of Deep Sternal Wound Infections and Their Impact on Long-Term Survival: A Propensity Analysis

• DOI: 10.1097/sap.0b013e31815acb6a
• Publication Date: 2008-08-19T07:15:54Z
• Authors: Cenk Cayci; Mark Russo; Faisal Cheema; Timothy Martens; Vefa Ozcan; Michael Argenziano; Mehmet C. Oz; Jeffrey Ascherman
• Keywords: Male; Sternum; Models, Statistical; Length of Stay; Middle Aged; Survival Analysis; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Humans; Minimally Invasive Surgical Procedures; Regression Analysis; Surgical Wound Infection; Female; Cardiac Surgical Procedures; Osteitis

The objectives of this study are to determine risk factors associated with deep sternal wound infections (DSWIs) following cardiac surgery, and describe their impact on long-term survival. Data was obtained from a departmental database. Analysis included 7,978 consecutive patients who underwent surgery between 1997 2003. To identify for DSWI, regression analysis performed. probability scores logistic were used propensity 2 groups. Kaplan-Meier log-rank test Cox proportional hazard models then in survival analysis. DSWI developed 123 (1.5%). Preoperative predictors body mass index >30 kg/m2 (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1 2.4; P < 0.05), diabetes mellitus (OR, CI, 1.6 3.4; 0.001), urgent operation 1.7; 1.2 2.6; smoking history within past year 2.7; 1.5 4.9; weeks 4.5; stroke 1.9; 3.1; 0.005). In addition, total length hospital stay 1.01; 1.01 1.02; 0.05) sepsis and/or endocarditis 5.1; 2.9 9.0; 0.001) also predictive DSWI. Patients had prolonged (40.3 days versus 16.1 days; higher 30-day mortality (1.6% 7.3% group, 0.05). There no differences groups 4-year 8-year rates, 77.2% 61.8%, respectively, compared 78.0% 67.5% without (P = 0.16). After adjustments preoperative, intraoperative, postoperative factors, the adjusted 0.9 (95% 0.6 1.2, 0.39). Though DSWIs increased early mortality, undergoing complicated by do not experience worse