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

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  • 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, Sweden
  • Astridur Petursdottir, Department of Surgery and Cardiothoracic Surgery, The National University Hospital of Iceland – Landspitali, Reykjavik, Iceland, Iceland
  • Martin Ingi Sigurdsson, Department of Surgery and Cardiothoracic Surgery, The National University Hospital of Iceland – Landspitali, Reykjavik, Iceland, Reykjavik University, Reykjavik, Iceland, Iceland
  • Anders Jeppsson
  • ,
  • Tomas Gudbjartsson
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 analyzed 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.
This retrospective cohort study included 114,869 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), and DSWI cases were compared to surgical patients not developing DSWI. Median follow-up was 5.5 years for the DSWI cases and 8.0 years for the non-infected patients.
Altogether, 1,516 patients (1.3%) developed DSWI, most of them after CABG (69.7%). Median time from surgery to surgical intervention was 15 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-, 5- and 10-year mortality was 12.8% vs. 4.5%, 28.9% vs. 14.1% and 57.0% vs. 33.1%, respectively (<0.001). DSWI patients had inferior unadjusted mortality compared to the group not developing the infection.
In this nation-wide cohort study, the unadjusted ninety-day mortality was almost threefold higher for DSWI patients than for non-DSWI patients and long-term all-cause mortality was also significantly increased in the DSWI group.
Original languageDanish
Publication year27 Nov 2019
Publication statusPublished - 27 Nov 2019
Event3rd Annual Research Meeting at the Department of Clinical Medicine -
Duration: 27 Nov 201927 Nov 2019

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Conference3rd Annual Research Meeting at the Department of Clinical Medicine
Period27/11/201927/11/2019

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