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正中开胸术后胸骨骨髓炎的发病率及危险因素

Incidence and risk factors for sternal osteomyelitis after median sternotomy.

作者信息

Cha Yoon Ki, Choi Min Suk, Bak So Hyeon, Kim Jeung Sook, Kim Chu Hyun, Chung Myung Jin

机构信息

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Department of Thoracic and Cardiovascular Surgery, Dongguk University Ilsan Hospital, Dongguk University School of Medicine, Goyang, Republic of Korea.

出版信息

J Thorac Dis. 2022 Apr;14(4):962-968. doi: 10.21037/jtd-21-1694.

DOI:10.21037/jtd-21-1694
PMID:35572909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9096311/
Abstract

BACKGROUND

Sternal osteomyelitis (OM) after median sternotomy is the rarest form of deep sternal wound infections (DSWIs). A retrospective study was implemented to evaluate the incidence and potential risk factors of sternal OM after median sternotomy.

METHODS

We analyzed 3,410 consecutive patients who underwent cardiothoracic surgery via median sternotomy from January 2005 to December 2019 at our institution. A sternal OM and control group without any sign of wound infections after median sternotomy were selected. Comparisons of the variables between the two groups were performed using the Student's -test and Fisher's exact tests. The association of potential risk factors with sternal OM was tested by logistic regression analysis.

RESULTS

A total of 16 patients (0.47%) had sternal OM after median sternotomy. None of the variables were different between the sternal OM patients and the control group including body mass index (BMI), diabetes mellitus (DM), hypertension (HTN), left ventricle (LV) function, transfusion, operation time, cardiopulmonary bypass (CPB) time and intensive care unit and ventilator days. By univariate analysis, none of the variables were associated with an increased risk of sternal OM.

CONCLUSIONS

The incidence of sternal OM after median sternotomy in our institution was 0.47% and there was no correlation between the known risk factors of DSWI and sternal OM in our study.

摘要

背景

正中开胸术后胸骨骨髓炎（OM）是深部胸骨伤口感染（DSWI）最罕见的形式。开展一项回顾性研究以评估正中开胸术后胸骨OM的发生率及潜在危险因素。

方法

我们分析了2005年1月至2019年12月在本机构接受正中开胸心胸手术的3410例连续患者。选取正中开胸术后发生胸骨OM的患者及无任何伤口感染迹象的对照组。两组之间的变量比较采用Student's -检验和Fisher精确检验。通过逻辑回归分析检验潜在危险因素与胸骨OM的相关性。

结果

共有16例患者（0.47%）在正中开胸术后发生胸骨OM。胸骨OM患者与对照组之间的变量无差异，包括体重指数（BMI）、糖尿病（DM）、高血压（HTN）、左心室（LV）功能、输血、手术时间、体外循环（CPB）时间以及重症监护病房和呼吸机使用天数。单因素分析显示，没有变量与胸骨OM风险增加相关。

结论

本机构正中开胸术后胸骨OM的发生率为0.47%，且在我们的研究中，已知的DSWI危险因素与胸骨OM之间无相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4575/9096311/9ddf36e9e9c5/jtd-14-04-962-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4575/9096311/9ddf36e9e9c5/jtd-14-04-962-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4575/9096311/9ddf36e9e9c5/jtd-14-04-962-f1.jpg

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