Document Detail

Tracheostomy: a risk factor for mediastinitis after cardiac operation.
MedLine Citation:
PMID:  11565649     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We studied whether tracheostomy after coronary artery bypass grafting (CABG) is associated with higher incidence of mediastinitis and mortality, and whether shorter intervals between median sternotomy and tracheotomy are associated with higher incidence of mediastinitis. METHODS: Patients (n = 6,057) undergoing CABG since March 1977 were reviewed. Patients requiring tracheostomy and those developing mediastinitis were identified. Mediastinitis diagnosis required positive culture of mediastinal tissue or fluid. RESULTS: After CABG, 88 patients had tracheostomy performed (1.45%). Seven patients receiving tracheostomy after developing mediastinitis were excluded. Of the remaining 81 patients, 7 developed mediastinitis (8.6%) compared with 44 of 5,969 (0.7%) who did not require tracheostomy (p < 0.001). Mortality in tracheostomy patients was 24.7% (20 of 81) compared with 5.2% in patients not requiring tracheostomy (316 of 5,969; p < 0.001). Patients not developing mediastinitis had tracheostomy placement an average of 25 days after CABG compared with 18.7 days for those developing mediastinitis (p = 0.141). CONCLUSIONS: Tracheostomy after CABG is associated with increased incidence of mediastinitis and mortality. In this review, the time interval between CABG and tracheostomy was not predictive of mediastinitis. A larger sample size would be required to be confident that there is no correlation.
J J Curtis; N C Clark; C A McKenney; J T Walls; R A Schmaltz; T L Demmy; J W Jones; W R Wilson; C C Wagner-Mann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  72     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-21     Completed Date:  2001-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  731-4     Citation Subset:  AIM; IM    
Department of Cardiothoracic Surgery, University of Missouri, Columbia, USA.
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MeSH Terms
Aged, 80 and over
Coronary Artery Bypass*
Mediastinitis / etiology*,  mortality
Middle Aged
Postoperative Care
Retrospective Studies
Risk Factors
Sternum / surgery
Surgical Wound Infection / etiology*
Time Factors
Tracheostomy / adverse effects*,  mortality
Comment In:
Ann Thorac Surg. 2002 Jun;73(6):2033; author reply 2033   [PMID:  12078826 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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