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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
1991-10-2
pubmed:abstractText
Previous studies have provided conflicting evidence as to whether an increased risk of mediastinitis is associated with use of the internal mammary artery as a coronary bypass graft. In this study the effects of internal mammary artery grafts on wound complications were analyzed in a prospective, nonrandomized fashion. At New York University Medical Center from January 1985 through May 1988, 2356 patients underwent isolated coronary revascularization. Among these patients 1394 received one or more internal mammary artery grafts (group I) and 962 had vein grafts only (group II). Group I had a mean age of 59.5 years versus 67.7 years in group II; diabetes was equally present in both groups (22.7% versus 24.7%). Operative mortality rate was 1.3% in group I and 5.6% in group II. Sternal infection was significantly more prevalent in group I (2.2%, 31/1394) than in group II (0.8%, 8/962). Multivariate analysis revealed that aortic crossclamp time, use of a single internal mammary artery graft, use of a double mammary graft, and diabetes were associated with increased risk of sternal infection. The use of bilateral internal mammary artery grafting doubled the odds ratio of the risk compared with use of a single mammary graft, and the combination of diabetes and double internal mammary artery grafts increased the odds ratio 13.9-fold. Patients with an internal mammary artery graft who had sternal infection had a longer period of hospitalization than patients without a mammary artery graft who had sternal infection. We conclude that the risk of sternal infection is increased by the use of an internal mammary artery graft, especially use of double mammary grafts in the presence of diabetes.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0022-5223
pubmed:author
pubmed:issnType
Print
pubmed:volume
102
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
342-6; discussion 346-7
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1991
pubmed:articleTitle
Sternal wound infections and use of internal mammary artery grafts.
pubmed:affiliation
Department of Surgery, New York University Medical Center, N.Y. 10016.
pubmed:publicationType
Journal Article