Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery

Detalhes bibliográficos
Autor(a) principal: Farsky,Pedro Silvio
Data de Publicação: 2011
Outros Autores: Graner,Humberto, Duccini,Pedro, Zandonadi,Eliana da Cassia, Amato,Vivian Lerner, Anger,Jaime, Sanches,Antonio Flavio de Almeida, Abboud,Cely Saad
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400019
Resumo: BACKGROUND: Sternal wound infection (SWI) after coronary artery bypass graft (CABG) surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. OBJECTIVE: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. METHODS: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student's t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P <0.05 was considered significant. RESULTS: The infection rate was 7.2% (143/1975). The multiple regression analysis found the following risk factors: female gender (OR 2.06; 95%CI 1.40-3.03; P<0.001), BMI&gt;40 kg/m² (OR 6.27, 95%CI 2.53-15.48; P<0.001), diabetes (OR 2.33; 95%CI 1.56-3.49; P<0.001), number of affected coronary arteries (OR 7.78; 95%CI 1.04-57.79; P<0.001) and use of bilateral internal thoracic artery (OR 3.85; 95%CI 2.10-7.07; P<0.001). Infected patients had a mean score of 9, whereas non-infected patients had a mean score of 7 (P<0.001). There was no correlation between microorganisms, scores and risk factors. CONCLUSION: Female gender, diabetes, BMI&gt;40 kg/m², number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution.
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spelling Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgeryInfectionRisk factorsMediastinitisMyocardial revascularizationBACKGROUND: Sternal wound infection (SWI) after coronary artery bypass graft (CABG) surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. OBJECTIVE: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. METHODS: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student's t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P <0.05 was considered significant. RESULTS: The infection rate was 7.2% (143/1975). The multiple regression analysis found the following risk factors: female gender (OR 2.06; 95%CI 1.40-3.03; P<0.001), BMI&gt;40 kg/m² (OR 6.27, 95%CI 2.53-15.48; P<0.001), diabetes (OR 2.33; 95%CI 1.56-3.49; P<0.001), number of affected coronary arteries (OR 7.78; 95%CI 1.04-57.79; P<0.001) and use of bilateral internal thoracic artery (OR 3.85; 95%CI 2.10-7.07; P<0.001). Infected patients had a mean score of 9, whereas non-infected patients had a mean score of 7 (P<0.001). There was no correlation between microorganisms, scores and risk factors. CONCLUSION: Female gender, diabetes, BMI&gt;40 kg/m², number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution.Sociedade Brasileira de Cirurgia Cardiovascular2011-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400019Brazilian Journal of Cardiovascular Surgery v.26 n.4 2011reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.5935/1678-9741.20110054info:eu-repo/semantics/openAccessFarsky,Pedro SilvioGraner,HumbertoDuccini,PedroZandonadi,Eliana da CassiaAmato,Vivian LernerAnger,JaimeSanches,Antonio Flavio de AlmeidaAbboud,Cely Saadeng2012-03-01T00:00:00Zoai:scielo:S0102-76382011000400019Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2012-03-01T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false
dc.title.none.fl_str_mv Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
title Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
spellingShingle Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
Farsky,Pedro Silvio
Infection
Risk factors
Mediastinitis
Myocardial revascularization
title_short Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
title_full Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
title_fullStr Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
title_full_unstemmed Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
title_sort Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery
author Farsky,Pedro Silvio
author_facet Farsky,Pedro Silvio
Graner,Humberto
Duccini,Pedro
Zandonadi,Eliana da Cassia
Amato,Vivian Lerner
Anger,Jaime
Sanches,Antonio Flavio de Almeida
Abboud,Cely Saad
author_role author
author2 Graner,Humberto
Duccini,Pedro
Zandonadi,Eliana da Cassia
Amato,Vivian Lerner
Anger,Jaime
Sanches,Antonio Flavio de Almeida
Abboud,Cely Saad
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Farsky,Pedro Silvio
Graner,Humberto
Duccini,Pedro
Zandonadi,Eliana da Cassia
Amato,Vivian Lerner
Anger,Jaime
Sanches,Antonio Flavio de Almeida
Abboud,Cely Saad
dc.subject.por.fl_str_mv Infection
Risk factors
Mediastinitis
Myocardial revascularization
topic Infection
Risk factors
Mediastinitis
Myocardial revascularization
description BACKGROUND: Sternal wound infection (SWI) after coronary artery bypass graft (CABG) surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. OBJECTIVE: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. METHODS: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student's t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P <0.05 was considered significant. RESULTS: The infection rate was 7.2% (143/1975). The multiple regression analysis found the following risk factors: female gender (OR 2.06; 95%CI 1.40-3.03; P<0.001), BMI&gt;40 kg/m² (OR 6.27, 95%CI 2.53-15.48; P<0.001), diabetes (OR 2.33; 95%CI 1.56-3.49; P<0.001), number of affected coronary arteries (OR 7.78; 95%CI 1.04-57.79; P<0.001) and use of bilateral internal thoracic artery (OR 3.85; 95%CI 2.10-7.07; P<0.001). Infected patients had a mean score of 9, whereas non-infected patients had a mean score of 7 (P<0.001). There was no correlation between microorganisms, scores and risk factors. CONCLUSION: Female gender, diabetes, BMI&gt;40 kg/m², number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution.
publishDate 2011
dc.date.none.fl_str_mv 2011-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400019
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400019
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/1678-9741.20110054
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
dc.source.none.fl_str_mv Brazilian Journal of Cardiovascular Surgery v.26 n.4 2011
reponame:Brazilian Journal of Cardiovascular Surgery (Online)
instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
instname_str Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron_str SBCCV
institution SBCCV
reponame_str Brazilian Journal of Cardiovascular Surgery (Online)
collection Brazilian Journal of Cardiovascular Surgery (Online)
repository.name.fl_str_mv Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
repository.mail.fl_str_mv ||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br
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