Sternal wound complications after primary isolated myocardial revascularization: the importance of the post-operative variables.
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.
Noyez
L
L
Department of Thoracic and Cardiac Surgery, -414-, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. l.noyez@thchir.azn.nl
van Druten
J A
JA
Mulder
J
J
Schroën
A M
AM
Skotnicki
S H
SH
Brouwer
R M
RM
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*