Mediastinitis after sternotomy. Mortality and hospital length of stay. Groupe parisien détude des sternotomies
Lucet, J.C.; Batisse, D.; Brücker, G.
Archives des Maladies du Coeur et des Vaisseaux 90(4): 471-475
1997
ISSN/ISBN: 0003-9683 PMID: 9238464 Document Number: 470715
The morbidity of deep sternal wound infections after sternotomy was assessed by a case-controlled study. The 41 cases were identified by a prospective enquiry over 4 months in 10 centres of cardiac surgery in the Paris region. The cases were compared with 41 non-infected controls, paired by centre, age, gender, ASA anaesthetic risk, stage of cardiac failure and type of surgery. The criteria of pairing were respected in 96% of cases. The mortality was 12% in the study population and 5% in the controls. Thirty-two of the 41 cases required reoperation for the sternal wound infection, usually to insert Redon drains after debridement of the wound. The total duration of the hospital stay was 53 days in the study cases and 30 days in controls, a median prolongation of the hospital stay of 23 days. The authors conclude that deep wound infection after sternotomy is responsible for almost doubling the duration of hospital stay. The economic consequences alone justify active research into the prevention of this complication.