Long-term outcome of patients with DSWI following cardiac surgery – preliminary results from the SWEDEHEART registry

Publikation: KonferencebidragPosterForskningpeer review

  • Alexander Emil Kaspersen
  • Susanne J. Nielsen, Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden., Department of Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden, Sverige
  • Astridur Petursdottir, Department of Surgery and Cardiothoracic Surgery, The National University Hospital of Iceland – Landspitali, Reykjavik, Iceland, Island
  • Martin Ingi Sigurdsson, Department of Surgery and Cardiothoracic Surgery, The National University Hospital of Iceland – Landspitali, Reykjavik, Iceland, Reykjavik University, Reykjavik, Iceland, Island
  • Anders Jeppsson, Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden., Department of Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden, Sverige
  • Tomas Gudbjartsson, Department of Surgery and Cardiothoracic Surgery, The National University Hospital of Iceland – Landspitali, Reykjavik, Iceland, Reykjavik University, Reykjavik, Iceland, Island
Background: Deep sternal wound infection (DSWI) is a major complication following open heart surgery with increased mortality and morbidity for the patient. The incidence is usually 1-4 % and 90-days mortality 0-16 %. Numerous studies have analysed short-term outcome of DSWI and defined risk factors. However, less is known about long-term survival and complications of these patients. We therefore studied long-term outcome of DSWI patients in a large nation-wide cohort of heart surgery patients.
Methods: This retrospective cohort study included 114,860 patients from the SWEDEHEART registry who underwent CABG (70.6 %), valve repair or replacement (18.6 %) or both (10.8 %) between 1997 to 2015. DSWI patients were identified by surgical intervention codes in the Swedish Patient Registry (reoperation for deep infection). DSWI cases were compared to non-infected patients and to 228,105 age and gender matched controls from the general Swedish population. Median follow-up was 8.0 years.
Results: Altogether, 1,515 patients (1.3 %) developed DSWI, most of them after CABG (69.7 %). Mean time from surgery to surgical intervention was 19.5 days (range 0-90 days). DSWI patients were older and had significantly higher BMI than those without. They had more often diabetes, hypertension, heart failure, previous stroke, renal failure and more often underwent combined CABG and valve surgery. Ninety-day mortality was 7.9 % vs. 3.0 % (p<0.001) in the DSWI vs. non-infected group, and 1- and 5-year mortality was 12.8 % vs. 4.5 % and 28.9 % vs. 14.1 %, respectively (<0.001). Both DSWI and non-DSWI patients had inferior unadjusted mortality compared to the control group (Figure 1).
Conclusion: In this nation-wide cohort study, the unadjusted ninety-day mortality was almost threffold higher for DSWI patients than for non-DSWI patients and long-term all-cause mortality was also significantly increased in the DSWI group.
Bidragets oversatte titelLong-term outcome of patients with DSWI following cardiac surgery – preliminary results from the SWEDEHEART registry
OriginalsprogDansk
Udgivelsesår5 sep. 2019
StatusUdgivet - 5 sep. 2019

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