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Cardiac reoperation in the intensive care unit
S M Fiser1, C G Tribble, J A Kern
1Department of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
The Annals of Thoracic Surgery
|June 28, 2001
Summary
Cardiac reoperations in the intensive care unit (ICU) do not increase sternal infection rates. This approach is safe and cost-effective, offering benefits over traditional operating room procedures.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Cardiac reoperations are frequently performed in the cardiac intensive care unit (CICU) at our institution.
- This contrasts with the traditional practice of returning patients to the operating room for reoperation.
Purpose of the Study:
- To test the hypothesis that performing cardiac reoperations in the CICU does not elevate the sternal infection rate.
- To evaluate the safety and efficacy of CICU reoperations.
Main Methods:
- A retrospective analysis of 6,908 adult cardiac surgery patients over nine years.
- Identified 340 patients (4.9%) who underwent reoperation in the CICU, with 289 survivors.
Main Results:
- A sternal wound infection rate of 2.1% (6 of 289 survivors) in the CICU reoperation group.
- This rate was not significantly different from the 1.9% infection rate in patients not requiring reoperation (121 of 6,497).
- Hospital charges for CICU reoperation ($1,972) were substantially lower than operating room reoperation ($5,832).
Conclusions:
- Reoperation within the CICU does not lead to a higher incidence of wound infections.
- Advantages include reduced costs, minimized transport risks for unstable patients, and improved timeliness of intervention.