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Risk factors for 1-year mortality after postoperative deep sternal wound infection
Eero Hämäläinen1, Jari Laurikka2,3, Heini Huhtala4
1Faculty of Medicine and Health TechnologyTampere UniversityArvo Ylpön katu 34 33500 TampereFinland.
Insights
Deep sternal wound infections after cardiac surgery lead to significant mortality. Postoperative factors like prolonged ICU stay and complications, not preoperative ones, increase the risk of death within one year.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Deep sternal wound infection (DSWI) is a severe complication following cardiac surgery.
- DSWI significantly increases patient mortality and morbidity.
- Identifying mortality risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the 1-year mortality rate associated with DSWI after cardiac surgery.
- To identify risk factors contributing to increased mortality in DSWI patients.
- To inform strategies for reducing mortality from DSWI.
Main Methods:
- Retrospective analysis of 7973 open-heart surgeries.
- Identification of patients with DSWI and recording of 1-year mortality status.
- Statistical analysis to identify risk factors for mortality.
Main Results:
- A total of 129 (1.6%) patients developed DSWI.
- The 1-year mortality rate for DSWI patients was 20.2%.
- Prolonged ICU stay, stroke, delirium, wound secretion, and co-infection were associated with increased mortality.
Conclusions:
- Mortality risk factors for DSWI are primarily postoperative.
- No significant preoperative or perioperative risk factors were identified.
- Emphasis on surgical quality and meticulous postoperative care is essential to reduce DSWI mortality.
Background And Aims:
A deep sternal wound infection is a life-threatening complication after cardiac surgery. This study was conducted to describe the mortality associated with postoperative deep sternal wound infections after cardiac surgery and to find risk factors linked to increased mortality in 1 year follow-up.
Material And Methods:
A total of 7973 open-heart surgeries were performed at Tampere University Hospital. Deep sternal wound infection patients were identified, their 1-year mortality status was recorded, and the related risk factors were analyzed.
Results:
We detected a total of 129 (1.6%) postoperative deep sternal wound infection patients. The 1-year mortality associated with a postoperative deep sternal wound infection was 20.2%. No preoperative or perioperative, statistically significant factors associated with increased 1-year mortality were found. A prolonged stay in an intensive care unit after surgery as well as stroke, delirium, wound secretion, and co-infection were associated with increased 1-year mortality.
Conclusion:
The risk factors found for increased 1-year mortality were all postoperative. The quality of surgical treatment as well as precise postoperative care and evaluation remain the most important factors to decrease later mortality due to deep sternal wound infections.
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