Risk factors for mediastinitis and endocarditis after cardiac surgery.
A prospective open-cohort study was performed in 838 adults undergoing coronary revascularization or valve surgery to define the risk factors for development of surgical site infections. Patients diagnosed with mediastinitis or endocarditis during follow-up were compared with patients with no such infection. After 1 year of follow-up, 22 (2.6%) patients had developed mediastinitis or endocarditis. No preoperative or intraoperative variables were identified as risk factors. By multivariate analysis of postoperative variables, respiratory insufficiency, microorganisms in blood cultures, and intensive care unit stay were independent risk factors for the development of these complications. The type of antibiotic prophylaxis had no influence on the incidence of organ or space infections after cardiac surgery.
Gualis
Javier
J
Department of Cardiac Surgery, Valladolid University Hospital, Valladolid, Spain. javgua@hotmail.com
Flórez
Santiago
S
Tamayo
Eduardo
E
Alvarez
Francisco Javier
FJ
Castrodeza
Javier
J
Castaño
Mario
M
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation; D002437:Cefazolin / Q000008:administration & dosage; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004334:Drug Administration Schedule; D004696:Endocarditis / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008480:Mediastinitis / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D012131:Respiratory Insufficiency / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D056346:Sternotomy / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002437:Cefazolin