Analysis of Risk Factors for Sternal Wound Infection After Off-Pump Coronary Artery Bypass Grafting

Abstract

Objective

To investigate the risk factors of deep sternal wound infection (DSWI) after off-pump coronary artery bypass grafting and its prevention and treatment strategy.

Methods

The clinical data of 465 patients who underwent OPCABG with a median chest incision were retrospectively analyzed. The patients were divided into the observation group (with DSWI, 32 cases) and the control group (without DSWI, 433 cases) according to the occurrence of DSWI. The preoperative, intraoperative, and postoperative clinical data relevant to DSWI were collected in both groups. The univariate and multivariate logistic regression analyses were adopted to analyze the risk factors for DSWI after OPCABG and investigateand its prevention and treatment strategy.

Results

DSWI occurred in 32 cases with an incidence of infection of 6.89%. There were 5 cases died in the observation group (with DSWI), the overall mortality rate was 1.07% and the intra-group mortality rate was 15.6%. There were 16 cases died in the control group (without DSWI) because of low cardiac output syndrome and multiple organ failure, the overall and intra-group mortality rates were 3.44% and 3.69% respectively. By analyzing the risk factors of DSWI between the two groups, the differences in age, body mass index (BMI), history of diabetes mellitus (DM), operation time, tracheal intubation time, time of stay in thecardiac care unit, blood transfusion (blood plasma)>800mL, blood transfusion (erythrocyte suspension)>6um, secondary thoracotomy were statistically significant between the observation and control groups (P < 0.05 in all).

Conclusion

Obesity, history of DM, prolonged operation time and tracheal intubation time, time of stay in CCU, utilization of blood product and secondary thoracotomy were DSWI independent risk factors after OPCABG.Some preventive measure should been implemented to reduce the incidence of DSWI, such as shorter operation time and tracheal intubation time, reducing the utilization of blood product.

Keywords:

• off-pump coronary artery bypass grafting
• sternal wound infection
• risk factor

Abbreviations

OPCABG, Off pump coronary artery bypass grafting; COPD, Chronic Obstructive Pulmonary Disease; SSWI, superficial sternal wound infection; DSWI, deep sternal wound infection.

Ethics

This study was conducted with approval from the institutional review committee of General Hospital of Ningxia Medical University. This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by The Ningxia Hui Autonomous Region key research and development plan in the field of social development projects (The general project, No: 2021BEG03070) In 2021.