Factors associated with the onset of mediastinitis in 2073 myocardial revascularizations

Introduction: Mediastinitis is a multifactorial entity which occurs in up to 4% of patients undergoing coronary artery bypass graft (CABG). It has a hospital mortality of 14% to 47%, which generates increased costs of care and deterioration of the quality of life and patient survival in the long ter...

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Detalles Bibliográficos
Autores Principales: Parada, Julián M., Carreño, Marisol, Camacho, Jaime, Sandoval, Néstor F., Umaña, Juan P.
Formato: Artículo (Article)
Lenguaje:Español (Spanish)
Publicado: Sociedad Colombiana de Cardiologia y Cirugia Cardiovascular 2014
Materias:
Age
Acceso en línea:https://repository.urosario.edu.co/handle/10336/22990
https://doi.org/10.1016/S0120-5633(14)70264-5
Descripción
Sumario:Introduction: Mediastinitis is a multifactorial entity which occurs in up to 4% of patients undergoing coronary artery bypass graft (CABG). It has a hospital mortality of 14% to 47%, which generates increased costs of care and deterioration of the quality of life and patient survival in the long term. Objective: To determine which clinical antecedents and factors related to the surgical procedure are associated with the occurrence of mediastinitis. Materials and methods: A nested case control study in a historical cohort of patients undergoing CABG in the period January 2005 to July 2011. Patients with mediastinitis were compared with a control group without mediastinitis taken from the same risk group in a 1:4 ratio and matched for date of surgery. The diagnosis of mediastinitis was made on clinical and laboratory criteria and surgical findings. Results: Thirty cases were identified in the related period. Factors associated with the occurrence of the event were: diabetes mellitus OR 2.3 (1.1 to 4.9), use of extracorporeal circulation OR 2.4 (1.1-5.5), OR 1 perfusion time, 1 (1.1 to 1.3) and patients older than 70 years OR 1.1 (1.2-1.4). Conclusions: Mediastinitis remains complications of low prevalence with devastating consequences. The clinical and economic impact of this complication should compel surgical groups to create prevention strategies based on knowledge of the risk factors of the population. © 2012 Sociedad Colombiana de Cardiología y Cirugía Cardiovascular. Published by Elsevier España, S.L. All rights reserved.