Risk factors for surgical-wound infection following cardiac surgery.
In a prospective study of 1,009 adult patients undergoing elective cardiac surgery at The Johns Hopkins Hospital, we determined the association between a variety of preoperative and operative parameters and the risk of postoperative sternal- or mediastinal-wound infection. Of the parameters reflecting nutritional state, only one, reduced level of albumin in serum, was significantly associated with sternal- or mediastinal-wound infection by univariate analysis. The final multiple logistic regression analysis indicated that four variables were significant (P less than .05) independent predictors of sternal- or mediastinal-wound infection: obesity (relative odds = 3.8; 95% confidence limits = 1.9-7.5), diabetes mellitus (relative odds = 2.6; 95% confidence limits = 1.4-4.8), length of hospital stay before surgery greater than five days (relative odds = 2.0; 95% confidence limits = 1.2-3.5), and current cigarette smoking (relative odds = 1.8; 95% confidence limits = 1.1-3.1). Of these variables, perhaps only smoking will lend itself routinely to attempts at intervention.
Nagachinta
T
T
Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205.
Stephens
M
M
Reitz
B
B
Polk
B F
BF
D000368:Aged; D001835:Body Weight; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*