Sternal wound complications after primary isolated myocardial revascularization: the importance of the post-operative variables.

Autor:	Noyez L; Department of Thoracic and Cardiac Surgery, -414-, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. l.noyez@thchir.azn.nl, van Druten JA, Mulder J, Schroën AM, Skotnicki SH, Brouwer RM
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2001 Apr; Vol. 19 (4), pp. 471-6.
DOI:	10.1016/s1010-7940(01)00610-8
Abstrakt:	Objective: Select pre-, peri-, and post-operative variables, predictive for sternal wound complications (SWC), in a clinical setting. Methods: We analyzed pre-, peri-, and post-operative data of 3815 patients who underwent a primary isolated bypass grafting. 100 patients (2.6%) had post-operative SWC. Unifactor and multifactor risk analysis, were used for statistical analysis. Results: Unifactor analysis identified age (P=0.05), obesity (P=0.001), lung disease (P=0.001), extracorporeal circulation >100 min (P=0.02), graft choice (P=0.01), post-operative low cardiac output, reoperation, nephrological, pulmonary problems (P<0.001) as risk factors. Multifactor analysis, identified obesity (P=0.005), reoperation (P=0.01), nephrological (P=0.0001), pulmonary problems (P=0.001) and No-IMA-use (P=0.05) as independent predictors. Age <50 years (P=0.04) decreased the risk for SWC. There is, however, an interaction of the graft-use and the pre-operative and post-operative predictors, that can mask the precise effect of the graft-use. Conclusion: Reoperation, nephrological and pulmonary problems are strong predictors, obesity and age independent preoperative risk factors for sternal wound complications.
Databáze:	MEDLINE
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