Risk factors for 1-year mortality after postoperative deep sternal wound infection

Scand J Surg. 2023 Mar;112(1):41-47. doi: 10.1177/14574969221139709. Epub 2022 Dec 1.

Abstract

Background and aims: A deep sternal wound infection is a life-threatening complication after cardiac surgery. This study was conducted to describe the mortality associated with postoperative deep sternal wound infections after cardiac surgery and to find risk factors linked to increased mortality in 1 year follow-up.

Material and methods: A total of 7973 open-heart surgeries were performed at Tampere University Hospital. Deep sternal wound infection patients were identified, their 1-year mortality status was recorded, and the related risk factors were analyzed.

Results: We detected a total of 129 (1.6%) postoperative deep sternal wound infection patients. The 1-year mortality associated with a postoperative deep sternal wound infection was 20.2%. No preoperative or perioperative, statistically significant factors associated with increased 1-year mortality were found. A prolonged stay in an intensive care unit after surgery as well as stroke, delirium, wound secretion, and co-infection were associated with increased 1-year mortality.

Conclusion: The risk factors found for increased 1-year mortality were all postoperative. The quality of surgical treatment as well as precise postoperative care and evaluation remain the most important factors to decrease later mortality due to deep sternal wound infections.

Keywords: DSWI; Postoperative infection; deep sternal wound infection; mediastinitis; mortality.

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Sternum / surgery
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / etiology