Risk factors for mortality in patients with mediastinitis after cardiac surgery
Summary Background Patients with mediastinitis after cardiac surgery have higher morbidity and mortality. Aims Describe the characteristics of patients with mediastinitis, determine the mortality within one month, and assess the risk factors associated with mortality. Methods Retrospective cohort st...
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| Veröffentlicht in: | Archives of cardiovascular diseases 2009-02, Vol.102 (2), p.119-125 |
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| creator | Lepelletier, Didier Poupelin, Luc Corvec, Stéphane Bourigault, Céline Bizouarn, Philippe Blanloeil, Yvonnic Reynaud, Alain Duveau, Daniel Despins, Philippe |
| description | Summary Background Patients with mediastinitis after cardiac surgery have higher morbidity and mortality. Aims Describe the characteristics of patients with mediastinitis, determine the mortality within one month, and assess the risk factors associated with mortality. Methods Retrospective cohort study including all adult patients with mediastinitis during the 2002–2006 period at the Nantes University Hospital. Multivariate analysis by logistic regression and Kaplan-Meier curve of survey were done. Results Nearly 5574 patients were operated during the study period, with a mediastinitis incidence rate of 0.7%, 28 patients (72%) had coronary artery bypass graft. The mortality rate increased from de 12.8% during hospital stay to 20.5% within one year. Only two deaths were associated with mediastinitis. The occurrence of a co-infection was the only independent risk factor associated with mortality (OR 13, P < 0.04). The instantaneous risk of death was increased by 7 in patient with co-infection, particularly mechanical ventilator-associated pneumonia (CR 1,97). Conclusion Mortality varied according to the duration of surveillance, and mediastinitis was not the major cause of death. Mechanical ventilator-associated pneumonia after mediastinitis increases the mortality and needs specific prevention. |
| doi_str_mv | 10.1016/j.acvd.2008.11.003 |
| format | Article |
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Aims Describe the characteristics of patients with mediastinitis, determine the mortality within one month, and assess the risk factors associated with mortality. Methods Retrospective cohort study including all adult patients with mediastinitis during the 2002–2006 period at the Nantes University Hospital. Multivariate analysis by logistic regression and Kaplan-Meier curve of survey were done. Results Nearly 5574 patients were operated during the study period, with a mediastinitis incidence rate of 0.7%, 28 patients (72%) had coronary artery bypass graft. The mortality rate increased from de 12.8% during hospital stay to 20.5% within one year. Only two deaths were associated with mediastinitis. The occurrence of a co-infection was the only independent risk factor associated with mortality (OR 13, P < 0.04). The instantaneous risk of death was increased by 7 in patient with co-infection, particularly mechanical ventilator-associated pneumonia (CR 1,97). Conclusion Mortality varied according to the duration of surveillance, and mediastinitis was not the major cause of death. Mechanical ventilator-associated pneumonia after mediastinitis increases the mortality and needs specific prevention.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2008.11.003</identifier><identifier>PMID: 19303579</identifier><language>eng</language><publisher>Amsterdam: Elsevier Masson SAS</publisher><subject>Adult ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - mortality ; Cardiology. Vascular system ; Cardiovascular ; Cross Infection - microbiology ; Cross Infection - mortality ; Facteur de risque ; Hospital Mortality ; Humans ; Internal Medicine ; Kaplan-Meier Estimate ; Logistic Models ; Mediastinitis ; Mediastinitis - microbiology ; Mediastinitis - mortality ; Medical sciences ; Mortality ; Mortalité ; Médiastinite ; Pneumonia, Ventilator-Associated - microbiology ; Pneumonia, Ventilator-Associated - mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Staphylococcus aureus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survie ; Survival ; Time Factors</subject><ispartof>Archives of cardiovascular diseases, 2009-02, Vol.102 (2), p.119-125</ispartof><rights>Elsevier Masson SAS</rights><rights>2009 Elsevier Masson SAS</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-b490685bcba63cf8fe76b51ccd12b3d8894314f03aa7e7ef2d08c508e67ad0063</citedby><cites>FETCH-LOGICAL-c439t-b490685bcba63cf8fe76b51ccd12b3d8894314f03aa7e7ef2d08c508e67ad0063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.acvd.2008.11.003$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21253459$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19303579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lepelletier, Didier</creatorcontrib><creatorcontrib>Poupelin, Luc</creatorcontrib><creatorcontrib>Corvec, Stéphane</creatorcontrib><creatorcontrib>Bourigault, Céline</creatorcontrib><creatorcontrib>Bizouarn, Philippe</creatorcontrib><creatorcontrib>Blanloeil, Yvonnic</creatorcontrib><creatorcontrib>Reynaud, Alain</creatorcontrib><creatorcontrib>Duveau, Daniel</creatorcontrib><creatorcontrib>Despins, Philippe</creatorcontrib><title>Risk factors for mortality in patients with mediastinitis after cardiac surgery</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>Summary Background Patients with mediastinitis after cardiac surgery have higher morbidity and mortality. Aims Describe the characteristics of patients with mediastinitis, determine the mortality within one month, and assess the risk factors associated with mortality. Methods Retrospective cohort study including all adult patients with mediastinitis during the 2002–2006 period at the Nantes University Hospital. Multivariate analysis by logistic regression and Kaplan-Meier curve of survey were done. Results Nearly 5574 patients were operated during the study period, with a mediastinitis incidence rate of 0.7%, 28 patients (72%) had coronary artery bypass graft. The mortality rate increased from de 12.8% during hospital stay to 20.5% within one year. Only two deaths were associated with mediastinitis. The occurrence of a co-infection was the only independent risk factor associated with mortality (OR 13, P < 0.04). The instantaneous risk of death was increased by 7 in patient with co-infection, particularly mechanical ventilator-associated pneumonia (CR 1,97). Conclusion Mortality varied according to the duration of surveillance, and mediastinitis was not the major cause of death. Mechanical ventilator-associated pneumonia after mediastinitis increases the mortality and needs specific prevention.</description><subject>Adult</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - mortality</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - mortality</subject><subject>Facteur de risque</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Mediastinitis</subject><subject>Mediastinitis - microbiology</subject><subject>Mediastinitis - mortality</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Mortalité</subject><subject>Médiastinite</subject><subject>Pneumonia, Ventilator-Associated - microbiology</subject><subject>Pneumonia, Ventilator-Associated - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Staphylococcus aureus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Survie</subject><subject>Survival</subject><subject>Time Factors</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo7rr6BzxILnqbtpJ0PhpEWBa_YGHBj3NIpxPNbE_3mEqvzL837QwrePCUEJ63UvUUIc8ZNAyYer1tnL8bGg5gGsYaAPGAnDOj5YYzbh7e34U6I08QtwCKa60ekzPWCRBSd-fk5nPCWxqdL3NGGudMd3MubkzlQNNE966kMBWkv1L5QXdhSA5LmlJJSF0sIVPvcn30FJf8PeTDU_IouhHDs9N5Qb69f_f16uPm-ubDp6vL641vRVc2fduBMrL3vVPCRxODVr1k3g-M92IwpmsFayMI53TQIfIBjJdggtJuqHOIC_LqWHef559LwGJ3CX0YRzeFeUGrNMhOg6ggP4I-z4g5RLvPaefywTKwq0a7tatGu2q0jFn4E3pxqr70dei_kZO3Crw8AQ69G2N2k094z1X_UrRy5d4cuVBd3KWQLfoq1FeROfhihzn9v4-3_8T9WO3XH2_DIeB2XvJULVtmkVuwX9aFr_sGA8ClMuI3yYqmSQ</recordid><startdate>20090201</startdate><enddate>20090201</enddate><creator>Lepelletier, Didier</creator><creator>Poupelin, Luc</creator><creator>Corvec, Stéphane</creator><creator>Bourigault, Céline</creator><creator>Bizouarn, Philippe</creator><creator>Blanloeil, Yvonnic</creator><creator>Reynaud, Alain</creator><creator>Duveau, Daniel</creator><creator>Despins, Philippe</creator><general>Elsevier Masson SAS</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090201</creationdate><title>Risk factors for mortality in patients with mediastinitis after cardiac surgery</title><author>Lepelletier, Didier ; Poupelin, Luc ; Corvec, Stéphane ; Bourigault, Céline ; Bizouarn, Philippe ; Blanloeil, Yvonnic ; Reynaud, Alain ; Duveau, Daniel ; Despins, Philippe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-b490685bcba63cf8fe76b51ccd12b3d8894314f03aa7e7ef2d08c508e67ad0063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - mortality</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cross Infection - microbiology</topic><topic>Cross Infection - mortality</topic><topic>Facteur de risque</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Mediastinitis</topic><topic>Mediastinitis - microbiology</topic><topic>Mediastinitis - mortality</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Mortalité</topic><topic>Médiastinite</topic><topic>Pneumonia, Ventilator-Associated - microbiology</topic><topic>Pneumonia, Ventilator-Associated - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Staphylococcus aureus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Survie</topic><topic>Survival</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lepelletier, Didier</creatorcontrib><creatorcontrib>Poupelin, Luc</creatorcontrib><creatorcontrib>Corvec, Stéphane</creatorcontrib><creatorcontrib>Bourigault, Céline</creatorcontrib><creatorcontrib>Bizouarn, Philippe</creatorcontrib><creatorcontrib>Blanloeil, Yvonnic</creatorcontrib><creatorcontrib>Reynaud, Alain</creatorcontrib><creatorcontrib>Duveau, Daniel</creatorcontrib><creatorcontrib>Despins, Philippe</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lepelletier, Didier</au><au>Poupelin, Luc</au><au>Corvec, Stéphane</au><au>Bourigault, Céline</au><au>Bizouarn, Philippe</au><au>Blanloeil, Yvonnic</au><au>Reynaud, Alain</au><au>Duveau, Daniel</au><au>Despins, Philippe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for mortality in patients with mediastinitis after cardiac surgery</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2009-02-01</date><risdate>2009</risdate><volume>102</volume><issue>2</issue><spage>119</spage><epage>125</epage><pages>119-125</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>Summary Background Patients with mediastinitis after cardiac surgery have higher morbidity and mortality. Aims Describe the characteristics of patients with mediastinitis, determine the mortality within one month, and assess the risk factors associated with mortality. Methods Retrospective cohort study including all adult patients with mediastinitis during the 2002–2006 period at the Nantes University Hospital. Multivariate analysis by logistic regression and Kaplan-Meier curve of survey were done. Results Nearly 5574 patients were operated during the study period, with a mediastinitis incidence rate of 0.7%, 28 patients (72%) had coronary artery bypass graft. The mortality rate increased from de 12.8% during hospital stay to 20.5% within one year. Only two deaths were associated with mediastinitis. The occurrence of a co-infection was the only independent risk factor associated with mortality (OR 13, P < 0.04). The instantaneous risk of death was increased by 7 in patient with co-infection, particularly mechanical ventilator-associated pneumonia (CR 1,97). Conclusion Mortality varied according to the duration of surveillance, and mediastinitis was not the major cause of death. Mechanical ventilator-associated pneumonia after mediastinitis increases the mortality and needs specific prevention.</abstract><cop>Amsterdam</cop><pub>Elsevier Masson SAS</pub><pmid>19303579</pmid><doi>10.1016/j.acvd.2008.11.003</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - mortality Cardiology. Vascular system Cardiovascular Cross Infection - microbiology Cross Infection - mortality Facteur de risque Hospital Mortality Humans Internal Medicine Kaplan-Meier Estimate Logistic Models Mediastinitis Mediastinitis - microbiology Mediastinitis - mortality Medical sciences Mortality Mortalité Médiastinite Pneumonia, Ventilator-Associated - microbiology Pneumonia, Ventilator-Associated - mortality Retrospective Studies Risk Assessment Risk Factors Staphylococcus aureus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Survie Survival Time Factors |
| title | Risk factors for mortality in patients with mediastinitis after cardiac surgery |
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