Pan Liang, Mo Ran, Zhou Qing, Wang Dongjin
Department of Cardiothoracic Surgery, The Nanjing Drum Tower Hospital, The Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, China.
J Thorac Dis. 2017 Sep;9(9):3031-3037. doi: 10.21037/jtd.2017.08.41.
Deep sternal wound infection (DSWI) is a severe complication following cardiac surgery. A retrospective study was implemented to determine the risks and clinical characteristics of DSWI after cardiac operation in the Chinese population.
We analysed 7,944 consecutive patients who underwent cardiac surgery via median sternotomy from January 2002 to December 2016 at our institution. Multiple logistic regression analysis was used to identify risk factors for DSWI.
A total of 106 patients (1.33%) suffered from DSWI; significant risk factors included body mass index (BMI) (P=0.02; OR=1.08; 95% CI: 1.01-1.16) and reoperation (P<0.01; OR=5.93; 95% CI: 2.88-12.25). The most common bacterium involved in DSWI was (23%). Among all DSWI patients, the overall survival rate of the group treated with flap reconstruction was significantly higher than that in the group treated with intravenous antibiotics and sternal debridement (87% 59%, P=0.01).
DSWI was associated with several risk factors. Effective intervention strategies could improve the outcome of patients undergoing cardiac surgery.
深部胸骨伤口感染(DSWI)是心脏手术后的一种严重并发症。开展了一项回顾性研究以确定中国人群心脏手术后DSWI的风险和临床特征。
我们分析了2002年1月至2016年12月在我院通过正中胸骨切开术接受心脏手术的7944例连续患者。采用多因素logistic回归分析确定DSWI的危险因素。
共有106例患者(1.33%)发生DSWI;显著危险因素包括体重指数(BMI)(P = 0.02;OR = 1.08;95%CI:1.01 - 1.16)和再次手术(P < 0.01;OR = 5.93;95%CI:2.88 - 12.25)。DSWI中最常见的细菌是(23%)。在所有DSWI患者中,皮瓣重建治疗组的总体生存率显著高于静脉使用抗生素和胸骨清创治疗组(87%对59%,P = 0.01)。
DSWI与多种危险因素相关。有效的干预策略可改善心脏手术患者的预后。