Risk factors associated with an increased risk of deep sternal wound infections in patients after coronary artery bypass grafting and heart defect surgery at the Department of Thoracic, Cardiac and Vascular Surgery of the hospital of Lithuanian University of Health Sciences

Abstract

Introduction Despite improvements over time with regard to morbidity, mortality and long-term survival, deep sternal wound infection (DSWI) continues to be a major complication after an open heart surgery (1,2). This is why it is important to identify possible risk factors for postoperative development of DSWI in patients undergoing coronary artery bypass grafting and valve replacement. Aim The aim of this study was to identify the risk factors for postoperative development of deep sternal wound infection in patients after coronary artery bypass grafting and heart defect surgery at the Department of Thoracic, Cardiac and Vascular Surgery of the hospital of Lithuanian University of Health Sciences. Methods This retrospective study analyzed 201 patients who underwent coronary artery bypass grafting and heart defect surgery between January 2017 and December 2017. The case group contained 45 patients who had to be reoperated because of deep sternal wound infection and the control group consisted of 156 randomly selected patients. For descriptive statistics we used means, median values, ranges, standard deviations and 95% confidence intervals where appropriate. Categorical data were analyzed using the chi-square or Fisher’s exact test. T-test and Mann-Whitney used to compare numerical variables. Logistic regression model adjusting for age, gender, were used to compare the risk of infection. A p value of<0.05 was considered to be statistically significant. STATA v13 was used for calculations. Results Logistic regression analysis revealed that independent risk factors for sternal wound infection were: high BMI (odds ratio [OR] 3.14), long duration of cardiopulmonary bypass (odds ratio [OR] 2.26) and intraoperative anemia (odds ratio [OR] -3.8). Conclusions This study demonstrates that higher BMI, anemia, and the duration of extracorporeal circulation are independent risk factors for the development of postoper[...].