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| Format: | Artículo científico |
| Language: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2012
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| Online Access: | https://www.redalyc.org/articulo.oa?id=398941886007 |
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Table of Contents:
- Long term mortality of deep sternal wound infection after coronary artery bypass surgery Aline Alexandra Iannoni de Moraes Cely Saad Abboud André Zeraik Limma Chammas Yara Santos Aguiar Lucas Cronemberger Mendes Jonatas Melo Neto Pedro Silvio Farsky Medicina Mortality Mortality Mediastinitis Mediastinitis Coronary artery bypass Background: Deep sternal wound infection and mediastinitis determine high in-hospital mortality. International studies show that these patients are also at increased cardiovascular mortality risk in long-term followup. However, data are scarce and there is no national data. Objectives: The aim of this study is to evaluate the mortality and incidence of cardiovascular events in longterm follow-up of patients suffering from deep sternal wound infection and mediastinitis. Methods: Case-control study, matched by propensity score in a 1:1 proportion, in patients submitted to coronary artery bypass grafting between 2005 and 2008 at the Institute Dante Pazzanese of Cardiology (São Paulo, SP, Brazil). The primary outcome was death. As a secondary outcome, we analyzed the composite event of myocardial infarction, new revascularization, stroke or death. Results: Of 1975 patients, 114 developed one of the infections. During the mean follow up of 3.6 years, deep sternal wound infection and mediastinitis increased the risk of death by 8.26 (95% CI 1.88-36.29, P = 0.005) and the incidence of combined end point by 2.61 (95% CI 1.2-5.69, P = 0.015). The Kaplan-Meier curves for both outcomes demonstrated that the greatest risk occurs in the first six months, followed by a period of stabilization and further increase in the incidence of events after 4 years of hospital discharge. The similarity between the curves of primary and secondary outcomes may be consequent to the predominance of death on the combined cardiovascular events. Conclusion: The presence of deep sternal wound infection or mediastinitis increased mortality in long-term follow-up in this sample of the Brazilian population according to the same pattern displayed by the developed countries. 2012 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941886007 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.3 Vol.27