Risk factors for median sternotomy dehiscence in cardiac surgery.
We retrospectively reviewed several risk factors for median sternotomy dihiscence in our cardiac surgery patients for a recent 18-month period. We studied these factors by univariate and multivariate analysis with respect to sternal dehiscence. Univariate analysis showed several factors to be significant: female sex (P = .03), obesity (P = .002), diabetes (P = .01), and prolonged postoperative ventilation (P = .006). Mammary artery bypass versus saphenous vein bypass only approached significance (14% vs 3%, P = .11). Multivariate analysis showed obesity (P = .002), diabetes (P = .041), and prolonged postoperative ventilation (P = .005) to be important. We conclude that obese diabetic women are at extremely high risk for sternotomy dehiscence, and mammary artery bypass in this high-risk population may be a relative contraindication.
McDonald
W S
WS
Department of Surgery, Louisiana State University Medical Center, Shreveport 71130-3932.
Brame
M
M
Sharp
C
C
Eggerstedt
J
J
D000328:Adult; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D009765:Obesity / Q000150:complications; D011237:Predictive Value of Tests; D012086:Reoperation; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology*