title: Trends in postcoronary artery bypass graft sternal wound dehiscence in a provincial population.
abstract: BACKGROUND
  It appears that the medical profile of patients undergoing coronary artery bypass graft (CABG) surgery has changed. The impact of this demographic shift on CABG outcomes, such as sternal wound dehiscence, is unclear.
  
  
  OBJECTIVE
  To quantify the incidence and trends of sternal wound dehiscence, quantify the demographic shift of those undergoing CABG and identify patient factors predictive of disease.
  
  
  METHODS
  A prospective analysis was performed on a historical cohort of consecutive patients who underwent CABG (without valve replacement) in Alberta between April 1, 2002 and November 30, 2009. The incidence and trends of sternal wound dehiscence were determined. In addition, the trend of the mean Charlson index score and European System for Cardiac Operative Risk Evaluation (EuroSCORE) (capturing patient comorbidities) was analyzed. Univariable analysis and multivariable models were performed to determine factors predictive of wound dehiscence.
  
  
  RESULTS
  A total of 5815 patients underwent CABG during the study period. The incidence proportion of sternal wound dehiscence in Alberta was 1.86% and the incidence rate was 1.98 cases per 100 person-years. Although both the EuroSCORE and Charlson scores significantly increased over the study period, the incidence of sternal wound dehiscence did not change significantly. Factors predictive of sternal wound dehiscence were diabetes (OR 2.97 [95% CI 1.73 to 5.10]), obesity (OR 1.55 [95% CI 1.05 to 2.27]) and female sex (OR 1.90 [95% CI 1.26 to 2.87]).
  
  
  CONCLUSIONS
  The incidence proportion of sternal wound dehiscence in Alberta was comparable with the incidence previously published in the literature. While patients undergoing CABG had worsening medical profiles, the incidence of sternal wound dehiscence did not appear to be increasing significantly.
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Calgary;
authors.forename: Christopher
authors.initials: C
authors.lastname: Doherty
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Calgary;
authors.forename: Duncan
authors.initials: D
authors.lastname: Nickerson
authors.affiliation: Department of Community Health Sciences, University of Calgary; ; Institute for Public Health, University of Calgary;
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Southern
authors.affiliation: Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta ; Division of Cardiac Surgery, Department of Surgery, University of Calgary, Calgary, Alberta.
authors.forename: Teresa
authors.initials: T
authors.lastname: Kieser
authors.affiliation: Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta ; Division of Cardiac Surgery, Department of Surgery, University of Calgary, Calgary, Alberta.
authors.forename: Jehangir
authors.initials: J
authors.lastname: Appoo
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Calgary;
authors.forename: Jeffery
authors.initials: J
authors.lastname: Dawes
authors.affiliation: Department of Biological Sciences, University of Calgary, Calgary, Alberta.
authors.forename: Michael A
authors.initials: MA
authors.lastname: De Souza
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Calgary;
authors.forename: Alan R
authors.initials: AR
authors.lastname: Harrop
authors.affiliation: Department of Community Health Sciences, University of Calgary; ; Institute for Public Health, University of Calgary; ; Department of Medicine, University of Calgary, Calgary, Alberta.
authors.forename: Doreen
authors.initials: D
authors.lastname: Rabi
keywords: Deep sternal wound infection; Sternal wound dehiscence