title: Mortality trends and the effects of débridement timing in the management of mediastinitis in the United States, 1998 to 2010.
abstract: BACKGROUND
  The authors examined the relationship between débridement delay and mortality for mediastinitis patients. The authors also assessed mortality trends for mediastinitis patients between 1998 and 2010.
  
  
  METHODS
  The authors conducted a retrospective cross-sectional study with data from the Nationwide Inpatient Sample, 1998 to 2010. They studied adult patients, 18 years of age or older, who were surgically treated for mediastinitis. They used a logistic regression model adjusted for patient demographic and clinical characteristics to evaluate the association between timing of first operative débridement and in-hospital mortality. Using their logistic model, they calculated the adjusted probability of in-hospital mortality for each year of the study.
  
  
  RESULTS
  Results showed that initial débridement after the fourth day of admission increased the odds of in-hospital mortality by 50 percent (odds ratio, 1.5; 95 percent confidence interval, 1.0 to 2.1). In addition, the adjusted probability of in-hospital mortality for an average patient treated for mediastinitis decreased from 10.6 percent in 1998 to 3.1 percent in 2010.
  
  
  CONCLUSIONS
  There is a survival advantage from timely initial débridement in mediastinitis patients.
  
  
  METHODS
  Risk, II.
authors.affiliation: Ann Arbor, Mich. From the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System.
authors.forename: Oluseyi
authors.initials: O
authors.lastname: Aliu
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Diaz-Garcia
authors.forename: Lin
authors.initials: L
authors.lastname: Zhong
authors.forename: Evan
authors.initials: E
authors.lastname: McGlinn
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003646:Debridement / Q000379:methods*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008480:Mediastinitis / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult