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

机译:深胸骨伤口感染对心脏手术后长期生存的影响

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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.
机译:背景本研究旨在探讨深部胸骨伤口感染对心脏手术后长期生存的影响。资料和方法在我们的机构数据库中,我们回顾性评估了1995年1月至2005年12月接受心脏直视手术的4732名成年患者的病历。使用logistic回归分析确定DSWI的预测因素。然后,根据先前确定的危险因素,将每名患有深胸骨伤口感染(DSWI)的患者与2名没有DSWI的对照进行匹配。在检查了由匹配产生的平衡后,使用配对检验比较了各组之间的短期死亡率,并使用Kaplan-Meier分析和Cox比例风险模型比较了长期存活率。结果总共分析了4732条记录。被调查人口的平均年龄为69.3±12.8岁。 DSWI发生在74(1.56%)位患者中。深层胸骨感染的重要独立预测因素是主动吸烟(OR 2.19,CI95 1.35–3.53,p = 0.001),肥胖症(OR 1.96,CI95 1.20–3.21,p = 0.007)和胰岛素依赖型糖尿病(OR 2.09, CI95 1.05–10.06,p = 0.016)。配对组的平均随访时间为125个月,IQR 99-162。配对后,DSWI组的院内死亡率较高(8.1%vs. 2.7%,p = 0.03),但DSWI并不是长期生存的独立预测因子(校正后的HR 1.5,CI95 0.7-3.2,p = 0.33)。 )。结论本报告中的结果清楚地表明,在成人普通心脏外科手术患者中,胸骨切开术后深部伤口感染不会影响长期生存。

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