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Co-Management Reduces Mortality in Post-Sternotomy Mediastinitis
David Fernández-de-Velasco1, Cristina Villamor-Jiménez1, Manuel Carnero-Alcázar2
1Department of Hospital Medicine, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
Surgical Infections
|November 8, 2022
Summary
A co-management model (CMM) significantly reduced mortality and treatment failure in patients with post-sternotomy mediastinitis (PSM). This multidisciplinary approach improved survival rates compared to the standard model for cardiac surgery patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Critical Care
Background:
- Post-sternotomy mediastinitis (PSM) is a severe complication following cardiac surgery.
- The effectiveness of multidisciplinary management for PSM remains under investigation.
Purpose of the Study:
- To evaluate the impact of a co-management model (CMM) versus a standard model (SM) on PSM patient outcomes.
- To compare survival time and treatment failure rates between CMM and SM groups.
Main Methods:
- Observational retrospective cohort study design.
- Comparison of PSM patients managed under CMM versus SM.
- Multivariable Cox regression analysis to identify mortality predictors.
Main Results:
- The CMM group showed significantly lower mortality (11.1%) compared to the SM group (60.3%).
- Treatment failure rates were lower in the CMM group (38.6%) versus the SM group (72.6%).
- CMM independently reduced overall mortality and treatment failure.
Conclusions:
- A co-management care model significantly decreases mortality in post-sternotomy mediastinitis patients.
- Implementing a CMM is beneficial for managing PSM after cardiac surgery.
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