Variables predicting adverse outcome in patients with deep sternal wound infection

Background. Mortality after deep sternal wound infection (DSWI) ranges betw een 5% and 47%. Variables predicting hospital mortality and prolonged hospi tal stay are still to be assessed. Methods. Among 13,420 patients who underwent cardiac surgery in our institu tion between 1979 and 1999, DSWI developed in 112 cases (0.8%). Multiple va riables were recorded prospectively and analyzed retrospectively as predict ors of hospital death and prolonged (>30 days) hospital stay. The analyzed variables were divided into three groups: (1) related to the patient, inclu ding demographic variables and preoperative conditions; (2) related to card iac operation; and (3) related to infection. Predictive variables were asse ssed by univariate and multivariate logistic regression analysis. Results. Hospital mortality was 16.9%. The hospital stay of the 93 discharg ed patients ranged between 16 and 180 days (mean 31.3 +/- 15.2). Length of cardiac operation, length of stay in intensive care unit, interval between symptoms of DSWI and wound debridement were found to be the most significan t predictors of bad outcome following DSWI. Conclusions. In our study demographic variables and preoperative conditions did not affect the prognosis of DSWI. Lower mortality rate and shorter hos pital stay could be achieved with earlier and aggressive treatment of DSWI. (Ann Thorac Surg 2001;71:324-31) (C) 2001 by The Society of Thoracic Surge ons.