Conservative treatment of vascular prosthetic graft infection is associated with high mortality.
BACKGROUND
The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections.


METHODS
Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with central prosthetic graft infections. Univariate and multivariate analyses were performed to define factors predictive of mortality.


RESULTS
Thirty-three men and 11 women (mean age, 71 years) were included. There was considerable comorbidity. Coagulase-negative Staphylococcus and S aureus were isolated in almost 50% of the patients. The mean follow-up duration was 5 years, during which 20 patients (46%) died. The main causes of death were related to vascular disease. Conservative treatment with antibiotics was the only variable with significant predictive value on multivariate analysis (hazard ratio, 3.62; 95% confidence interval, 1.17-11.24; P = .02).


CONCLUSIONS
Conservative treatment of prosthetic graft infections was associated with high mortality; therefore, it should be limited to a specific group. Patients who are not capable of undergoing open repair may benefit from conservative management. Otherwise, aggressive open treatment seems indicated.
Saleem
Ben R
BR
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Meerwaldt
Robbert
R
Tielliu
Ignace F J
IF
Verhoeven
Eric L G
EL
van den Dungen
Jan J A M
JJ
Zeebregts
Clark J
CJ
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000401:mortality / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000628:therapy; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene