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A Prospective Multi-Institutional Cohort Study of Mediastinal Infections After Cardiac Operations

Tuesday, February 6, 2018

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Source Name: The Annals of Thoracic Surgery


Louis P. Perrault, Katherine A. Kirkwood, Helena L. Chang, John C. Mullen, Brian C. Gulack, Michael Argenziano, Annetine C. Gelijns, Ravi K. Ghanta, Bryan A. Whitson, Deborah L. Williams, Nancy M. Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A. Rose, John D. Puskas, Eugene H. Blackstone, Richard D. Weisel, Michael E. Bowdish

The authors participated in a multi-institutional prospective study to evaluate the frequency, risk factors, and outcomes of patients who suffer mediastinal infection after cardiac surgery.  A total of 5,158 patients were enrolled, and there were 43 infections in 41 patients (0.79 cumulative incidence) occurring at a median time of 20 days after surgery.  The authors discovered the following risk factors for the development of mediastinitis: 

  • higher body mass index
  • higher creatinine
  • peripheral vascular disease
  • preoperative steroids
  • ventricular assist device or transplant surgery
  • postoperative hyperglycemia in nondiabetics

Readmission rates and mortality were five times higher in patients who developed mediastinitis.

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