Prevalence of leg wound complications after coronary artery bypass grafting: determination of risk factors.
BACKGROUND
The reported prevalence of leg wound complications after coronary artery bypass grafting is 2% to 24%. Decreased length of hospital stay for patients who have this surgical procedure poses new care requirements in both acute care and community settings.


OBJECTIVE
To determine the prevalence of postoperative leg wound complications in patients undergoing coronary artery bypass grafting and the risk factors associated with these complications.


METHODS
In this prospective, observational study, 547 consecutive patients who had coronary artery bypass grafting alone or in combination with other cardiac surgical procedures were examined for evidence of leg wound complications each day after surgery during hospitalization. After discharge, problems were detected by home care nurses.


RESULTS
The prevalence of leg wound complications was 6.8%. Factors significant by multiple logistic regression included preoperative hospitalization, use of an Ace elastic bandage in the operating room, the length of time the leg incision remained open in the operating room, and administration of nicardipine intravenously in the intensive care unit. Odds ratios were calculated for each variable. Premorbid factors such as diabetes or peripheral vascular disease were not predictive of complications. On average, most problems occurred on postoperative day 10, when many patients were at home.


CONCLUSIONS
The results highlight the need to detect complications early, in both the hospital and the community settings. The determination of factors related to poor outcomes may assist clinicians in improving healthcare delivery.
Goldsborough
M A
MA
Department of Surgery, Johns Hopkins Hospital and University, Baltimore, Md., USA.
Miller
M H
MH
Gibson
J
J
Creighton-Kelly
S
S
Custer
C A
CA
Wallop
J M
JM
Greene
P S
PS
D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing