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. 2011 Oct-Dec;26(4):624-9.
doi: 10.5935/1678-9741.20110054.

Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery

Pedro Silvio Farsky  1 , Humberto Graner, Pedro Duccini, Eliana da Cassia Zandonadi, Vivian Lerner Amato, Jaime Anger, Antonio Flavio de Almeida Sanches, Cely Saad Abboud
Affiliations

Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery

Pedro Silvio Farsky et al. Rev Bras Cir Cardiovasc. 2011 Oct-Dec.

Abstract

Background: Sternal wound infection (SWI) after coronary artery bypass graft (CABG) surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures.

Objective: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital.

Methods: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student's t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P <0.05 was considered significant.

Results: The infection rate was 7.2% (143/1975). The multiple regression analysis found the following risk factors: female gender (OR 2.06; 95%CI 1.40-3.03; P<0.001), BMI>40 kg/m² (OR 6.27, 95%CI 2.53-15.48; P<0.001), diabetes (OR 2.33; 95%CI 1.56-3.49; P<0.001), number of affected coronary arteries (OR 7.78; 95%CI 1.04-57.79; P<0.001) and use of bilateral internal thoracic artery (OR 3.85; 95%CI 2.10-7.07; P<0.001). Infected patients had a mean score of 9, whereas non-infected patients had a mean score of 7 (P<0.001). There was no correlation between microorganisms, scores and risk factors.

Conclusion: Female gender, diabetes, BMI>40 kg/m², number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution.

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