Factors associated with deep sternal wound infection and haemorrhage following cardiac surgery in Victoria.
Serious non-fatal complications of cardiac surgery include deep sternal wound infection (DSWI) and haemorrhage. Understanding the factors associated with these complications (both pre-operatively and intra-operatively) may aid in the prevention and avoidance of such complications. The aim of the current report is to identify factors associated with DSWI and haemorrhage for all patients undergoing cardiac surgical procedures in Victorian public hospitals from July 2001 to June 2005. Multiple logistic regression analysis incorporating preoperative and intraoperative variables was used to identify risk factors for DSWI and haemorrhage. There were 153 cases of DSWI (1.3%) and 413 cases of haemorrhage (3.5%) in 11,848 patients. The risk factors differ between DSWI and haemorrhage, with pre-operative factors being more commonly associated with DSWI and intra-operative factors associated with haemorrhage. Strategies directed towards minimising modifiable pre-operative risk factors (diabetes, preoperative dialysis, respiratory disease, being overweight and angina CCS Class 3 or 4) may reduce the incidence of DSWI. Improvements in operative factors (perfusion time, ventricular assist device, intraaortic balloon pump and aortic dissection) and surgical technique, may impact on reducing the incidence of haemorrhage.
Robinson
Penelope J
PJ
NHMRC Centre of Clinical Research Excellence in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia.
Billah
Baki
B
Leder
Karin
K
Reid
Christopher M
CM
D000368:Aged; D000787:Angina Pectoris / Q000150:complications; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D019992:Databases as Topic / Q000706:statistics & numerical data; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006353:Heart-Assist Devices / Q000009:adverse effects; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008480:Mediastinitis / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D012140:Respiratory Tract Diseases / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016896:Treatment Outcome; D014739:Victoria / Q000453:epidemiology