Deep sternal wound infections following open heart surgery in Iceland. A population-based study

• Published in: Scandinavian Cardiovascular Journal
• Main Authors: Steingrimsson, Steinn, Gottfredsson, Magnus, Kristinsson, Karl G, Gudbjartsson, Tomas
• Other Authors: Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis 2008
• Subjects: Thoracic Surgery; Surgical Wound Infection; Mediastinitis; Risk Factors; Peripheral Vascular Diseases; Staphylococcus aureus; Sternum; Iceland
• Online Access: http://hdl.handle.net/2336/30562; https://doi.org/10.1080/14017430801919557

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field Objective. The aim of this nationwide case-control study was to study the epidemiology and identify risk factors of deep sternal wound infections (DSWI) in Iceland. Patients and methods. Between 1997-2004, 1 650 adults underwent open cardiac surgery in Iceland. For every infected patient four control subjects were chosen (n =163), matched for time of operation. The groups were compared by multivariable logistic regression analysis. Results. Forty one patients (2.5%) developed DSWI, most often following CABG (76%). The most common pathogens were Staphylococcus aureus (39%) and coagulase-negative staphylococci (24%). All except two patients underwent debridement and rewiring of the sternum. Length of hospital stay was significantly longer in the DSWI group with a trend for increased hospital mortality and significantly greater 1-year mortality (17% vs. 5%, p =0.02). History of stroke (OR 5.12), peripheral arterial disease (OR 5), corticosteroid use (OR 4.25), smoking (OR 3.66) and re-operation for bleeding (OR 4.66) were the strongest independent predictors for DSWI. Conclusion. Incidence of DSWI in Iceland (2.5%) is comparable to other recently published studies, with similar risk factors and significantly reduced survival at one year following the infection.