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PREDICTING THE PROBABILITY OF THE STERNAL WOUND INFECTION IN PATIENTS UNDERGOING CARDIAC SURGERY

https://doi.org/10.24884/0042-4625-2018-177-1-11-15

Abstract

objective. The aim of the study is to create the model for predicting the probability of the sternal wound infection in patients undergoing cardiac surgery after heart operations with the use of longitudinal median sternotomy. Material and methods. The results of treatment of 485 cardiosurgical patients were analyzed; these patients were divided into 2 groups. In the 1st group (265 patients), the prophylaxis of sternal infection was carried out according to a standard procedure, the method of «elimination of sternal infection» was applied in the 2nd group (220 patients). The rate of sternal infection was estimated depending on risk factors. The multiple logistic regression was used to create the model for predicting the risk of sternal wound infection. Results. The created model for predicting the risk of sternal wound infection includes the following factors: application of the method of «elimination of sternal infection» (OR=1871.9; p=0.036); diabetes mellitus type 2 (OR=0.207; p=0.022); the risk according to EuroScore Logistic (OR=1.04; p=0.04); the duration of stay in ICU (OR=1.15, p=0.006). Conclusion: The created model for predicting the risk of sternal wound infection in cardiosurgical patients is excellent effective (p=0.036). The proposed technique for the prevention of sternal infection allowed to reduce the incidence of its occurrence in patients from 7.9 to 0.45 %.

 

About the Authors

G. G. Khubulava
Saint Petersburg State Pediatric Medical University, St. Petersburg; S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation, Saint-Petersburg
Russian Federation

Department of Cardiovascular Surgery;

The First Department and Clinic of Surgery (postgraduate medical education) named after P. A. Kupriyanov



N. N. Shikhverdiev
Saint Petersburg State Pediatric Medical University, St. Petersburg; S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation, Saint-Petersburg
Russian Federation

Department of Cardiovascular Surgery;

The First Department and Clinic of Surgery (postgraduate medical education) named after P. A. Kupriyanov



P. R. Vogt
Saint Petersburg State Pediatric Medical University, St. Petersburg
Russian Federation
Department of Cardiovascular Surgery


S. P. Marchenko
Saint Petersburg State Pediatric Medical University, St. Petersburg; S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation, Saint-Petersburg
Russian Federation

Department of Cardiovascular Surgery;

The First Department and Clinic of Surgery (postgraduate medical education) named after P. A. Kupriyanov



V. V. Suvorov
Saint Petersburg State Pediatric Medical University, St. Petersburg
Russian Federation
Department of Cardiovascular Surgery


References

1. Хубулава Г. Г., Марченко С. П., Дубова Е. В., Суворов В. В. Роль модифицированной ультрафильтрации в уменьшении системных проявлений воспаления в кардиохирургии // Педиатр. 2016. Т. 7, № 1. С. 106–110 [Hubulava G. G., Marchenko S. P., Dubova E. V., Suvorov V. V. Rol’ modificirovannoj ul’trafil’tracii v umen’s henii sistemnyh projavlenij vospalenija v kardiohirurgii // Pediatr. 2016. Vol. 7, № 1. P. 106–110].

2. Bryan C. S., Yarbrough W. M. Preventing deep wound infection after coronary artery bypass grafting : a review // Tex. Heart Inst. J. 2013. № 40. P. 125–139.

3. Filsoufi F., Castillo J. G., Rahmanian P. B., Broumand S. R., Silvay G., Carpentier A., Adams D. H. Epidemiology of deep sternal wound infection in cardiac surgery // J. Cardiothorac. Vasc. Anesth. 2009. № 23. P. 488–494.

4. Graf K., Ott E., Vonberg R. P., Kuehn C., Haverich A., Chaberny I. F. Economic aspects of deep sternal wound infections // Eur. J. Cardiothorac. Surg. 2010. № 37. P. 893–896.

5. Kanafani Z. A., Arduino J. M., Muhlbaier L. H., Kaye K. S., Allen K. B., Carmeli Y., Corey G. R., Cosgrove S. E., Fraser T. G., Harris A. D., Karchmer A. W., Lautenbach E., Rupp M. E., Peterson E. D., Straus W. L., Fowler V. G. Incidence of and preoperative risk factors for Staphylococcus aureus bacteremia and chest wound infection after cardiac surgery // Infect. Control. Hosp. Epidemiol. 2009. № 30. P. 242–248.

6. Litmathe J., Boeken U., Bohlen G. Systemic inflammatory response syndrome after extracorporeal circulation : a predictive algorithm for the patient at risk // Hellenic. J. Cardiol. 2011. Vol. 52. P. 493–500.

7. Morisaki A., Hosono M., Sasaki Y., Hirai H., Sakaguchi M., Nakahira A., Seo H., Suehiro S., Shibata T. Evaluation of risk factors for hospital mortality and current treatment for poststernotomymediastinitis // Gen. Thorac. Cardiovasc. Surg. 2011. Vol. 59, № 4. P. 261–267.

8. Nishida H., Grooters R. K., Soltanzadeh H., Thieman K. C., Schneider R. F., Kim W. P. Discriminate use of electrocautery on the median sternotomy incision. A 0.16 % wound infection rate // J. Thorac. Cardiovasc. Surg. 1991. Vol. 101. P. 488–493.

9. Rabbolini D. J., Ange N., Walters G. D., Pidcock M., Randall K. L. Systemic capillary leak syndrome : recognition prevents morbidity and mortality// Intern. Med. J. 2013. Vol. 43, № 10. P. 1145–1147.

10. SalehiOmran A., Karimi A., Ahmadi S.H., Davoodi S., Marzban M., Movahedi N., Abbasi K., Boroumand M. A., Davoodi S., Moshtaghi N. Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG) incidence, risk factors and mortality // BMC Infect. Dis. 2007. № 7. P. 112–120.

11. Torina A. G., Petrucci O., Oliveira P. P. The effects of modified ultrafiltration on pulmonary function and transfusion requirements in patients underwent coronary artery bypass graft surgery // Rev. Bras. Cir. Cardiovasc. 2010. Vol. 25, № 1. P. 59–65.

12. Vogt P. R. Elimination of deep and superficial sternal wound infection // Abstr. 30­th cardivasc. surg. sympos. Zurs, Austria. 2012. Vol. 30. P. 15.

13. Wang F. D., Chang C. H. Risk factors of deep sternal wound infections in coronary artery bypass graft surgery // J. Cardiovasc.Surg. (Torino). 2000. № 41. P. 709–713.


Review

For citations:


Khubulava G.G., Shikhverdiev N.N., Vogt P.R., Marchenko S.P., Suvorov V.V. PREDICTING THE PROBABILITY OF THE STERNAL WOUND INFECTION IN PATIENTS UNDERGOING CARDIAC SURGERY. Grekov's Bulletin of Surgery. 2018;177(1):11-15. (In Russ.) https://doi.org/10.24884/0042-4625-2018-177-1-11-15

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