Description

Lu et al identified risk factors for sternal wound infections following coronary artery bypass graft (CABG) surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from The Cardiothoracic Centre in Liverpool, England.


Patient selection: CABG

 

Outcomes: sternal infection and 4-year survival

 

Predictors for superficial sternal wound infection:

(1) BMI >= 30 kg per square meter (odds ratio 2.0)

(2) NYHA class 3 or 4 (odds ratio 1.6)

(3) use of bilateral internal mammary arteries (odds ratio 3.8)

(4) increasing number of coronary artery grafts (odds ratio 1.6 per graft)

(5) re-exploration for bleeding (odds ratio 3.7)

 

Predictors for deep sternal wound infection:

(1) increased duration of mechanical ventilation (odds ratio 1.04 for every 10 hours)

(2) insulin-dependent diabetes mellitus (odds ratio 5.0)

(3) peripheral vascular disease (odds ratio 3.7)

 

Predictors for any sternal wound infection by logistic regression model:

(1) BMI >= 30 kg per square meter (odds ratio 2.0)

(2) NYHA class 3 or 4 (odds ratio 1.6)

(3) use of bilateral internal mammary arteries (odds ratio 3.2)

(4) increasing number of coronary artery grafts (odds ratio 1.5 per graft)

(5) re-exploration for bleeding (odds ratio 3.1)

(6) increased duration of mechanical ventilation (odds ratio 1.12 for every 10 hours)


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