Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
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| Format: | Artículo científico |
| Langue: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2011
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| _version_ | 1876446344301772800 |
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| author | Pedro Silvio Farsky |
| author_facet | Pedro Silvio Farsky |
| contents | Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery Pedro Silvio Farsky Humberto Graner Pedro Duccini Eliana da Cassia Zandonadi Vivian Lerner Amato Jaime Anger Antonio Flavio de Almeida Sanches Cely Saad Abboud Medicina Infection risk factors mediastinitis myocardial revascularization Background: Sternal wound infection (SWI) after coronary artery bypass graft (CABG) surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. Objective: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. Methods: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student’s t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P <0.05 was considered significant. Results: The infection rate was 7.2% (143/1975). The multiple regression analysis found the following risk factors: female gender (OR 2.06; 95%CI 1.40-3.03; P<0.001), BMI>40 kg/m2 (OR 6.27, 95%CI 2.53-15.48; P<0.001), diabetes (OR 2.33; 95%CI 1.56-3.49; P<0.001), number of affected coronary arteries (OR 7.78; 95%CI 1.04-57.79; P<0.001) and use of bilateral internal thoracic artery (OR 3.85; 95%CI 2.10-7.07; P<0.001). Infected patients had a mean score of 9, whereas non-infected patients had a mean score of 7 (P<0.001). There was no correlation between microorganisms, scores and risk factors. Conclusion: Female gender, diabetes, BMI>40 kg/m2 , number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution. 2011 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941883019 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.26 |
| format | Artículo científico |
| id | redalyc_398941883019 |
| institution | Redalyc |
| language | en |
| publishDate | 2011 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery Pedro Silvio Farsky Medicina Infection risk factors mediastinitis myocardial revascularization Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery Pedro Silvio Farsky Humberto Graner Pedro Duccini Eliana da Cassia Zandonadi Vivian Lerner Amato Jaime Anger Antonio Flavio de Almeida Sanches Cely Saad Abboud Medicina Infection risk factors mediastinitis myocardial revascularization Background: Sternal wound infection (SWI) after coronary artery bypass graft (CABG) surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. Objective: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. Methods: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student’s t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P <0.05 was considered significant. Results: The infection rate was 7.2% (143/1975). The multiple regression analysis found the following risk factors: female gender (OR 2.06; 95%CI 1.40-3.03; P<0.001), BMI>40 kg/m2 (OR 6.27, 95%CI 2.53-15.48; P<0.001), diabetes (OR 2.33; 95%CI 1.56-3.49; P<0.001), number of affected coronary arteries (OR 7.78; 95%CI 1.04-57.79; P<0.001) and use of bilateral internal thoracic artery (OR 3.85; 95%CI 2.10-7.07; P<0.001). Infected patients had a mean score of 9, whereas non-infected patients had a mean score of 7 (P<0.001). There was no correlation between microorganisms, scores and risk factors. Conclusion: Female gender, diabetes, BMI>40 kg/m2 , number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution. 2011 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941883019 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.26 |
| title | Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery |
| topic | Medicina Infection risk factors mediastinitis myocardial revascularization |
| url | https://www.redalyc.org/articulo.oa?id=398941883019 |