title: Sternal wound complications after primary isolated myocardial revascularization: the importance of the post-operative variables.
abstract: OBJECTIVE
  Select pre-, peri-, and post-operative variables, predictive for sternal wound complications (SWC), in a clinical setting.
  
  
  METHODS
  We analyzed pre-, peri-, and post-operative data of 3815 patients who underwent a primary isolated bypass grafting. 100 patients (2.6%) had post-operative SWC. Unifactor and multifactor risk analysis, were used for statistical analysis.
  
  
  RESULTS
  Unifactor analysis identified age (P=0.05), obesity (P=0.001), lung disease (P=0.001), extracorporeal circulation >100 min (P=0.02), graft choice (P=0.01), post-operative low cardiac output, reoperation, nephrological, pulmonary problems (P<0.001) as risk factors. Multifactor analysis, identified obesity (P=0.005), reoperation (P=0.01), nephrological (P=0.0001), pulmonary problems (P=0.001) and No-IMA-use (P=0.05) as independent predictors. Age <50 years (P=0.04) decreased the risk for SWC. There is, however, an interaction of the graft-use and the pre-operative and post-operative predictors, that can mask the precise effect of the graft-use.
  
  
  CONCLUSIONS
  Reoperation, nephrological and pulmonary problems are strong predictors, obesity and age independent preoperative risk factors for sternal wound complications.
authors: Department of Thoracic and Cardiac Surgery, -414-, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. l.noyez@thchir.azn.nl
authors: L
authors: L
authors: Noyez
authors: J A
authors: JA
authors: van Druten
authors: J
authors: J
authors: Mulder
authors: A M
authors: AM
authors: Schroën
authors: S H
authors: SH
authors: Skotnicki
authors: R M
authors: RM
authors: Brouwer
mesh_terms: D000368:Aged; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D018570:Risk Assessment; D012307:Risk Factors; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology*