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14 August 2013 : Original article  

Influence of deep sternal wound infection on long-term survival after cardiac surgery

Sebastian ColombierBEF, Ulf KesslerC, Enrico FerrariAD, Ludwig K. von SegesserADF, Denis A. BerdajsADEF

DOI: 10.12659/MSM.889191

Med Sci Monit 2013; 19:668-673


BACKGROUND: This study aimed to investigate the influence of deep sternal wound infection on long-term survival following cardiac surgery.

MATERIAL AND METHODS: In our institutional database we retrospectively evaluated medical records of 4732 adult patients who received open-heart surgery from January 1995 through December 2005. The predictive factors for DSWI were determined using logistic regression analysis. Then, each patient with deep sternal wound infection (DSWI) was matched with 2 controls without DSWI, according to the risk factors identified previously. After checking balance resulting from matching, short-term mortality was compared between groups using a paired test, and long-term survival was compared using Kaplan-Meier analysis and a Cox proportional hazard model.

RESULTS: Overall, 4732 records were analyzed. The mean age of the investigated population was 69.3±12.8 years. DSWI occurred in 74 (1.56%) patients. Significant independent predictive factors for deep sternal infections were active smoking (OR 2.19, CI95 1.35–3.53, p=0.001), obesity (OR 1.96, CI95 1.20–3.21, p=0.007), and insulin-dependent diabetes mellitus (OR 2.09, CI95 1.05–10.06, p=0.016). Mean follow-up in the matched set was 125 months, IQR 99–162. After matching, in-hospital mortality was higher in the DSWI group (8.1% vs. 2.7% p=0.03), but DSWI was not an independent predictor of long-term survival (adjusted HR 1.5, CI95 0.7–3.2, p=0.33).

CONCLUSIONS: The results presented in this report clearly show that post-sternotomy deep wound infection does not influence long-term survival in an adult general cardio-surgical patient population.

Keywords: Preoperative Care, Postoperative Complications - etiology, Kaplan-Meier Estimate, Follow-Up Studies, Cardiac Surgical Procedures - adverse effects, Sternum - surgery, Time Factors, Wound Infection - pathology

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01 November 2023 : Editorial  

Editorial: Factors Driving New Variants of SARS-CoV-2, Immune Escape, and Resistance to Antiviral Treatments as the End of the COVID-19 Pandemic is Declared

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville,

DOI: 10.12659/MSM.942960

Med Sci Monit 2023; 29:e942960


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750