Risk Factors for Postoperative Mediastinitis After Open Heart Surgery

Dilara İNAN, Rabin SABA, İlhan GÖLBAŞI, İsa AK, Cengiz TÜRKAY, Latife MAMIKOĞLU
2002 Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi  
At the Cardiac Surgery Department of the Akdeniz University Hospital, between 1993 and 1999, postoperative mediastinitis developed in 20 of 1476 patients who had underwent open-heart surgery; the incidence was found to be 13%. These cases were analyzed in a case-control study designed to identify risk factors for postoperative mediastinitis. The following significant risk factors were identified; as preoperative factors: History of diabetes mellitus, functional class IV, preoperative prolonged
more » ... > 3 days) antibiotic use, as postoperative factors: Prolonged stay in the intensive-care unit, prolonged central venous catheterization and reoperation. Type and duration of surgery were not significantly associated with postoperative mediastinitis. All patients with postoperative mediastinitis had purulent discharge on surgical wound, and other clinical manifestations were fever, sternal dehiscence and sternal pain. The mortality rate was 20% (4 of 20) among the patients with mediastinitis. All patients were treated with extensive debridement and long term parenteral antibiotics.
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