Risk factors for sternal wound XXXX and mid-term survival following coronary artery bypass surgery.

@entity1 @entity28 @entity2737 @entity281 @entity676 @entity204
OBJECTIVE: To identify risk factors for sternal wound @entity281 following coronary artery bypass surgery (CABG), and to compare early and mid-term survival outcome. METHODS: Data were prospectively collected for 4228 @entity1 who underwent CABG surgery between April 1997 and March 2001. One hundred and nine (2.6%) @entity1 developed sternal wound @entity281 . We used logistic regression to identify independent risk factors associated with @entity2737 . @entity1 records were linked to the National Strategic Tracing Service, which records all @entity204 in the UK, to establish current vital status. Deaths occurring over time were described using Kaplan-Meier techniques. To control for differences in @entity1 characteristics, we used Cox proportional hazards analysis to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: The results of the logistic regression analysis found that the independent predictors of sternal wound @entity281 were @entity28 (odds ratio (OR) 2.0; P<0.001), New York Heart Association class >/=3 (OR 1.6; P=0.022), use of bilateral internal mammary arteries (OR 3.2; P<0.001), increasing number of grafts (OR 1.5; P<0.001), re-exploration for bleeding (OR 3.1; P=0.011), and increased duration of mechanical ventilation (for every 10 h (OR 1.12; P<0.001)). Three hundred and forty one (8.1%) @entity204 occurred during the study period with mean follow up of 3.2+/-1.3 years. The crude HR of mid-term mortality for sternal wound @entity281 @entity1 was 2.51 (95% CI 1.59-3.94, P<0.001). After adjustment for pre, intra and post-operative factors, the adjusted HR of mid-term mortality for sternal wound @entity281 @entity1 was 1.64 (95% CI 1.03-2.61, P=0.037). The adjusted freedom from @entity204 at 30 days, @entity676 years was 96.8, 93.7, 91.4 and 86.7%, respectively, compared with 98.1, 96.1, 94.7 and 91.7% for @entity1 without sternal wound infections. CONCLUSIONS: In conclusion, we have identified risk factors for sternal wound @entity281 , many of which are modifiable. We have also shown that there is a significant increase in mortality in @entity1 with sternal wound @entity281 during a 4-year follow-up period after CABG.
