Deep sternal wound infection after coronary artery bypass: How to manage?
| Autor: | Fahad Al Shammari, Riyad Tarazi, Moataz Salah Eldin, Tareq Aleinati, Jamal Alfadli, Mohamed Abdelrahman Badawy |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Risk Assessment law.invention Risk Factors law Diabetes mellitus Odds Ratio medicine Humans Surgical Wound Infection Coronary Artery Bypass Aged Retrospective Studies Univariate analysis Chi-Square Distribution business.industry Incidence Patient Selection Mortality rate Incidence (epidemiology) General Medicine Middle Aged medicine.disease Sternotomy Mediastinitis Wound infection Intensive care unit Surgery Logistic Models medicine.anatomical_structure Kuwait Multivariate Analysis Female Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Asian Cardiovascular and Thoracic Annals. 22:649-654 |
| ISSN: | 1816-5370 0218-4923 |
| Popis: | Mediastinitis is a devastating sternal wound complication. The aim of this study was to identify the incidence, risk factors, mortality, and different treatment modalities of mediastinitis after isolated coronary artery bypass grafting. From January 2007 to May 2010, 1424 patients who underwent isolated coronary artery bypass grafting were studied retrospectively; 1398 (group 1) had no mediastinitis, and 26 (group 2) developed mediastinitis. The diagnosis and classification of mediastinitis were based on the criteria of the Center for Disease Control and Prevention and the Emory classification, respectively. Multivariate analysis showed only 4 risk factors: diabetes mellitus, obesity, prolonged postoperative intensive care unit stay, and prolonged intubation time. On univariate analysis, female sex, renal failure, and reexploration for bleeding were also significant risk factors. The incidence of mediastinitis (1.83%) and the subsequent mortality rate (7.69%) were comparable to those of previous reports. Early detection and aggressive management of mediastinitis play major roles in decreasing the related mortality and morbidity. The Emory classification with some modification is very helpful in choosing the proper treatment modality. |
| Databáze: | OpenAIRE |
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