Details

Autor(en) / Beteiligte

• Gaudino, Mario
• Cancelli, Gianmarco
• Gerry, Stephen
• Taggart, David P.
• Ratnatunga
• Westaby, S.
• Cook, J.
• Wallis, C.
• Widenka, K.
• Gocol, R.
• Hudziak, D.
• Mrozek, R.
• Ezakadan, D.
• Matalanis, G.
• Newcomb, A.
• Polidano, P.
• Gerbo, S.
• O'Keefe, P.
• von Oppell, U.
• Evans, J.
• Trivedi, U.
• Lewis, M.
• Cooter, N.
• Joyce, E.
• Parker, J.
• Tocewicz, K.
• Bolkowski, M.
• Duralek, A.
• Skarysz, J.
• Swiech, W.
• Szmagala, X.
• Hasan, R.
• Keenan, D.
• Prendergast, B.
• McLaughlin, K.
• Oomen, A.
• El-Gamel, A.
• John, L.
• Andrews, M.
• Nair, S.
• Sudarshan, C.
• Large, S.
• Lao-Sirieix, S.
• Wilkinson, A.
• Osmond, J.
• Griffin, S.
• Dickson, J.
• Spyt, T.
• Gershlick, A.
• Hickey, M.
• Szostek, J.
• Amrani, M.
• Dreyfus, G.
• Bahrami, T.
• de Robertis, F.
• Baig, K.
• Vohra, H.
• Konstanty-Kalandyk, J.
• Wanderley, J.
• Pepper, J.
• Gavino, J.
• Wang, S.F.
• Kanagasaby, R.
• Ryan, H.
• Mohama, E.
• McDonnell, P.
• Siondalski, P.
• Rogowski, J.
• Jagielak, D.
• Naguboyin
• Sajja, L. Rao
• Dandu, B.
• Peddireddy, J.
• Briffa, N.
• Shaw, P.
• Casabona, R.
• Dato, G. Actis
• Del Ponte, S.
• Forsennati, F.
• Sansone, F.
• Demartino, A.
• Dihmis, W.
• McQuade, L.
• Duran-Rosas, A.
• Lau, G.
• Trescher, K.
• Schor, I.
• Kassal, H.
• Trehan, N.
• Goel, M.
• Bazaz, S.
• Singh, A.
• Mishka, Y.
• Gupta, R.
• Szafron, B.
• Pacholewicz, J.
• Krason, M.
• Wojarski
• Kurowicki, A.
• Stacel, T.

Titel

Association between sternal wound complications and 10-year mortality following coronary artery bypass grafting

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2023-08, Vol.166 (2), p.532-539.e4

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2023

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• To evaluate the association between sternal wound complications (SWC) and long-term mortality in the Arterial Revascularization Trial. Participants in the Arterial Revascularization Trial were stratified according to the occurrence of postoperative SWC. The primary outcome was all-cause mortality at long-term follow-up. The secondary outcome was major adverse cardiovascular events. Three thousand one hundred two patients were included in the analysis; the median follow-up was 10 years. 115 patients (3.7%) had postoperative SWC: 85 (73.9%) deep sternal wound infections and 30 (26.1%) sterile SWC that required sternal reconstruction. Independent predictors of SWC included diabetes (odds ratio [OR], 2.77; 95% CI, 1.79-4.30; P < .001), female sex (OR, 2.73; 95% CI, 1.71-4.38; P < .001), prior stroke (OR, 2.59; 95% CI, 1.12-5.98; P = .03), chronic obstructive pulmonary disease (OR, 2.44; 95% CI, 1.60-3.71; P < .001), and use of bilateral internal thoracic artery (OR, 1.70; 95% CI, 1.12-2.59; P = .01). Postoperative SWC was significantly associated with long-term mortality. The Kaplan-Meier survival estimate was 91.3% at 5 years and 79.4% at 10 years in patients without SWC, and 86.1% and 64.3% in patients with SWC (log rank P < .001). The rate of major adverse cardiovascular events was also higher among patients who had SWC (n = 51 [44.3%] vs 758 [25.4%]; P < .001). Using multivariable analysis, the occurrence of SWC was independently associated with long-term mortality (hazard ratio, 1.81; 95% CI, 1.30-2.54; P < .001). In the Arterial Revascularization Trial, postoperative SWC although uncommon were significantly associated with long-term mortality. Summary of the findings of the study. ART, Arterial Revascularization Trial; SWC, sternal wound complications; HR, hazard ratio; CABG, coronary artery bypass grafting. [Display omitted]