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Risk factors for mediastinitis following median sternotomy in children

Jessica Kagen1, Ebbing Lautenbach, Warren B Bilker

  • 1Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

The Pediatric Infectious Disease Journal
|June 29, 2007
PubMed

Insights

Mediastinitis after pediatric heart surgery is linked to genetic syndromes, high anesthesia risk scores, and prolonged pacing wire use. Identifying these risk factors can improve patient outcomes and preventative strategies.

Area of Science:

  • Pediatric Cardiothoracic Surgery
  • Infectious Complications
  • Medical Risk Factor Analysis

Background:

  • Mediastinitis is a severe complication following pediatric cardiothoracic surgery.
  • Risk factors for mediastinitis in this population are not well-defined.
  • This study aimed to identify predictors of mediastinitis in children undergoing cardiac surgery.

Purpose of the Study:

  • To identify risk factors associated with mediastinitis in pediatric patients after median sternotomy.
  • To inform clinical practice and improve preventative measures for post-surgical mediastinitis.

Main Methods:

  • A case-control study design was employed.
  • Patients undergoing median sternotomy between 1995 and 2003 were included.
  • Statistical analyses included univariate, logistic, and multinomial regression.

Main Results:

  • The study included 43 mediastinitis cases and 184 controls.
  • Factors significantly associated with mediastinitis were: genetic syndromes (aOR 4.5), ASA score >3 (aOR 3.4), and pacing wires >3 days (aOR 15.8).
  • Female sex and median age of 128 days were noted but not primary risk factors.

Conclusions:

  • Genetic syndromes, high American Society of Anesthesiologists (ASA) scores, and prolonged use of intracardiac pacing wires are significant risk factors for mediastinitis.
  • These findings highlight specific patient characteristics and procedural elements that increase mediastinitis risk in pediatric cardiothoracic surgery.
  • Early identification and management of these factors may reduce the incidence of this devastating complication.
Abstract

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