AI Article Synopsis
- The study focuses on the incidence of mediastinitis, a serious complication, in cardiovascular surgery patients, with a review of 1038 cases from May 2007 to June 2009.
- The occurrence of mediastinitis was noted in 2.4% of patients, primarily affecting those with diabetes, smoking history, obesity, and other health issues, and it was linked to a high mortality rate (32%).
- Key complications included respiratory issues, strokes, and organ failures, with Staphylococcus aureus identified as the most common bacterial culprit; coronary artery bypass grafting was specifically associated with a heightened risk of infection.
Article Abstract
Objective: To report the incidence of mediastinitis in cardiovascular surgery postoperation.
Methods: The records of all 1038 patients who underwent cardiovascular surgical procedures between May/2007 and June/2009 were reviewed. All operations were performed in Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE.
Results: The complication occurred within, on average, 13 days after operation, in total of 25 (2.4%), eight (32%) deaths occurred. Several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. Mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (IC 3.448.30, P=0.0001). High rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). Bacterial cultures of exudates were positive in 84% of patients; Staphylococcus aureus was the most responsible pathogen (28.8%).
Conclusion: Mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. The disease stays with low incidence, but still with high lethality. Coronary bypass was associated to major risk of infection development.
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