RISK-FACTORS FOR DEEP STERNAL WOUND-INFECTION AFTER STERNOTOMY - A PROSPECTIVE, MULTICENTER STUDY

Several risk factors for deep sternal wound infection after sternotomy remain unclear. To assess and compare risk factors among units, a pro spective study included 1830 patients in 10 units during a 4-month per iod: 960 underwent coronary artery bypass grafting and 870 underwent o ther procedures. According to the Centers for Disease Control and Prev ention definitions, 2.3% of patients (42/1830) acquired a deep sternal wound infection. Independent risk factors for deep sternal wound infe ction were obesity, coronary artery bypass grafting, reoperation, and postoperative inotropic support. Independent risk factors after corona ry artery bypass grafting were obesity, bilateral internal thoracic ar tery grafting, reoperation, and postoperative inotropic support. In al l five of the units usually performing bilateral internal thoracic art ery graftings, this procedure was associated with high risk of deep st ernal wound infection. Duration of operation was a major risk factor i n comparison of the unit with the highest risk of deep sternal wound i nfection with the other nine units; this suggests that parameters rela ted to the perioperative period were involved. Multicenter surveillanc e is useful to determine reliable risk factors for deep sternal wound infection, to define a high-risk population before operation, and to a ssess unit-specific risk factors.