We. Trick et al., Modifiable risk factors associated with deep sternal site infection after coronary artery bypass grafting, J THOR SURG, 119(1), 2000, pp. 108-114
Citations number
24
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective: Our objective was to identify risk factors for deep sternal site
infection after coronary artery bypass grafting at a community hospital. M
ethods: We compared the prevalence of deep sternal site infection among pat
ients having coronary artery bypass grafting during the study (January 1995
-March 1998) and pre-study (January 1992-December 1994) periods. We compare
d any patient having a deep sternal site infection after coronary artery by
pass graft surgery during the study period (case-patients) with randomly se
lected patients who had coronary artery bypass graft surgery but no deep st
ernal site infection during the same period (control-patients), Results: De
ep sternal site infections were significantly more common during the study
than during the pre-study period (30/1796 [1.7%] vs 9/1232 [0.7%]; P =.04).
Among 30 case-patients, 29 (97%) returned to the operating room for sterna
l debridement or rewiring, and 2 (7%) died. In multivariable analyses, cefu
roxime receipt 2 hours or more before incision (odds ratio = 5.0), diabetes
mellitus with a preoperative blood glucose level of 200 mg/dL or more (odd
s ratio = 10.2), and staple use for skin closure (odds ratio = 4.0) were in
dependent risk factors for deep sternal site infection. Staple use was a ri
sk factor only for patients with a normal body mass index. Conclusions: App
ropriate timing of antimicrobial prophylaxis, control of preoperative blood
glucose levels, and avoidance of staple use in patients with a normal body
mass index should prevent deep sternal site infection after coronary arter
y bypass graft operations.