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Risk factors for sternal wound infection in men versus women
L C Hussey1, L Hynan, B Leeper
1College of Nursing and Health Professions, University of North Carolina at Charlotte, Charlotte, NC, USA.
Insights
Differences in sternal wound infection risk factors between sexes after cardiac surgery were investigated. Smoking, single internal mammary artery use, and older age in women were identified as key differentiating factors.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease Epidemiology
- Gender-Based Medicine
Background:
- Post-cardiac surgery complication rates exhibit sex-based differences.
- Sternal wound infection (SWI) is a severe complication, yet its sex-specific incidence remains uncompared.
- Understanding these differences is crucial for targeted prevention strategies.
Purpose of the Study:
- To compare the prevalence of 21 risk factors for sternal wound infection (SWI) between male and female cardiac surgery patients.
- To identify specific risk factors associated with SWI that differ significantly between sexes.
Main Methods:
- Retrospective review of 306 cardiac surgery patients (1989-1999) across three US hospitals.
- Analysis of 21 predefined risk factors for sternal wound infection.
- Comparison of risk factor frequencies between patients with and without SWI, stratified by sex.
Main Results:
- Three risk factors showed significant sex-based differences: smoking and single internal mammary artery grafting were more prevalent in men.
- Women were significantly older than men at the time of cardiac surgery.
- Logistic regression confirmed that age over 70, smoking, and single internal mammary artery grafting predicted SWI group, with sex-related variations.
Conclusions:
- This study highlights potential sex-based disparities in sternal wound infection risk following cardiac surgery.
- Identified differing risk factor rates (smoking, single internal mammary artery use, age) warrant further investigation.
- Additional research is necessary to elucidate the impact of these sex-specific risk factors on SWI occurrence.
Background:
Differences between men and women in complication rates after cardiac surgery have been reported. The rate of one of the most severe postoperative complications, sternal wound infection, has not been compared between the sexes.
Objective:
To compare the frequencies of 21 risk factors for sternal wound infection between men and women.
Methods:
Records of 306 patients who had cardiac surgery between 1989 and 1999 at 3 different hospitals in the southwestern and southeastern United States were reviewed for 21 risk factors. Of the 306 patients, 115 (25 women and 90 men) had experienced a sternal wound infection and 191 randomly selected patients (52 women and 139 men) had not.
Results:
Three risk factors occurred at significantly different rates in men and women. Smoking and use of a single internal mammary artery for grafting were more common in men than women. Women were older than men at the time of cardiac surgery. Logistic regression analyses showed that the 3 dichotomous risk factors (use of single internal mammary artery for grafting, smoking, age > 70 years) that univariate analysis indicated were significantly related to sex could also be used to predict infection group.
Conclusions:
This study contributes to the awareness of the possible differences between men and women in the risk of sternal wound infection developing after cardiac surgery. Although 3 risk factors occurred at significantly different rates in men and women, further research is needed to determine the effects that these differences in risk factors may have on the occurrence of sternal wound infection in men and women.