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首页> 外文期刊>Seminars in thoracic and cardiovascular surgery >Multivariate analysis of risk factors for deep and superficial sternal infection after coronary artery bypass grafting at a tertiary care medical center.
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Multivariate analysis of risk factors for deep and superficial sternal infection after coronary artery bypass grafting at a tertiary care medical center.

机译：三级医疗中心冠状动脉搭桥术后深部和浅表胸骨感染危险因素的多因素分析。

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摘要

Identification of modifiable risk factors for sternal infection is essential for the development and institution of practices that decrease the incidence of these infections. This study analyzed 4004 consecutive patients undergoing coronary artery bypass grafting performed at a single institution between January 1996 and May 2003. Specific risk factors for both superficial and deep sternal wound infection were identified by univariate and multivariate analysis. The incidence of superficial sternal wound infections was 2.2% (N = 87) while the incidence of deep sternal wound infections was 1.8% (N = 73). Risk factors for superficial sternal infection identified by multivariate analysis include increasing body mass index (BMI) (OR 1.089, 95% CI 1.057-1.122, P < 0.001), female gender (OR 1.412, 1.108-1.717, P = 0.036), active smoking (OR 1.856, 1.079-3.193, P = 0.025), utilization of bilateral internal mammary arteries (OR 7.546, 3.175-17.935, P < 0.001), and transfusion of > or =4 units of packed red blood cells postoperatively (OR 2.009, 1.158-3.485, P = 0.013). Risk factors for deep sternal infection include increasing BMI (OR 1.077, 1.042-1.114, P < 0.001), diabetes mellitus (OR 2.412, 1.376-4.231, P = 0.002), and transfusion with > or =2 units of platelets postoperatively (OR 2.787, 1.279-6.071, P = 0.010). These data suggest that cessation of smoking, improved blood glucose management, preoperative weight loss, limitation of transfusions, and discriminate use of bilateral internal mammary arteries are all practices that may decrease the incidence of postoperative wound complications following coronary revascularization.
机译：确定胸骨感染的可改变危险因素对于减少这些感染发生率的行为的发展和实施至关重要。这项研究分析了1996年1月至2003年5月在同一家机构中进行的4004例连续冠状动脉搭桥术患者。通过单因素和多因素分析确定了浅表和深胸骨伤口感染的具体危险因素。浅表胸骨伤口感染的发生率为2.2％（N = 87），而深胸骨伤口感染的发生率为1.8％（N = 73）。通过多变量分析确定的浅表胸骨感染的危险因素包括体重指数（BMI）升高（OR 1.089，95％CI 1.057-1.122，P <0.001），女性（OR 1.412，1.108-1.717，P = 0.036），活跃吸烟（OR 1.856，1.079-3.193，P = 0.025），双侧乳腺内动脉利用率（OR 7.546，3.175-17.935，P <0.001），术后输注>或= 4单位填充红细胞（OR 2.009 ，1.158-3.485，P = 0.013）。深胸骨感染的危险因素包括BMI升高（OR 1.077，1.042-1.114，P <0.001），糖尿病（OR 2.412，1.376-4.231，P = 0.002），术后输注≥2个或2个单位的血小板（OR 2.787，1.279-6.071，P = 0.010）。这些数据表明，戒烟，改善血糖管理，术前体重减轻，输血受限以及区别使用双侧乳内动脉都是可以降低冠状动脉血运重建术后并发症发生率的方法。

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