Mediastinitis After Cardiovascular Operations: A Case-Control Study of Risk Factors
| Autor: | Bengt Gårdlund, Catarina Y. Bitkover |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Time Factors Adrenergic beta-Antagonists Body Mass Index Diabetes Complications Postoperative Complications Risk Factors Internal medicine Diabetes mellitus medicine Humans Cardiac Surgical Procedures Risk factor Cardiopulmonary Bypass business.industry Body Weight Case-control study Odds ratio Adrenergic beta-Agonists medicine.disease Mediastinitis Confidence interval Surgery Case-Control Studies Cardiology Cardiology and Cardiovascular Medicine business Complication Body mass index |
| Zdroj: | The Annals of Thoracic Surgery. 65:36-40 |
| ISSN: | 0003-4975 |
| Popis: | Background . An analysis of risk factors for postoperative mediastinitis can lead to a better understanding of the pathogenesis of this complication and to more effective preventive measures. Methods . This case-control study of 37 patients and 74 matched controls evaluated 54 potential risk factors. Results . Nine variables were significantly associated with increased risk of postoperative mediastinitis: total operation time ( p = 0.0013), high body-mass index ( p = 0.0033), use of β-adrenergic drugs before the onset of infection ( p = 0.0037), long cardiopulmonary bypass time ( p = 0.0072), long aortic cross-clamp time ( p = 0.0075), presence of diabetes ( p = 0.0122), high body weight ( p = 0.0130), and use and duration of temporary pacing wires ( p = 0.0293 and p = 0.0241 respectively). In a conditional logistic regression analysis, use of β-adrenergic drugs before the onset of infection ( p = 0.0058; odds ratio 19.7; 95% confidence limits, 2.37 and 163.7) and body mass index ( p = 0.0082; odds ratio 1.27; 95% confidence limits, 1.06 and 1.52) were independently associated with a significantly increased risk of postoperative mediastinitis. Conclusions . Obesity and use of β-adrenergic drugs, which is indicative of obstructive respiratory problems, were the most important risk factors suggesting that mechanical strain on the sternotomy and sternal instability may precede infection. Targeted preventive measures for these groups could be justified. |
| Databáze: | OpenAIRE |
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