Predictors of Sternal Wound Infection Post Cardiac Surgery in a Saudi Centre: A Case Control Study

Abstract

Abstract Background: Post Cardiac Surgery Sternal Wound Infection (SWI) remains an important cause of extra morbidity, mortality and cost. The objective was to identify risk factors of SWI in a Cardiac Centre in Eastern Saudi Arabia as part of investigation into Surveillance variance in the local rates of SWI. Methods: We included Cases and controls from a cross section of patients who underwent major Cardiac surgery between 2017–2020 matched for age, gender and time of surgery. Explanatory Logistic Regression Model was fitted to estimate the risk factors. Results: N = 204 (51 cases and 153 controls matching ratio 1:3, from a source population of 985 patients). factors significantly associated with SWI in the final Multivariate Model: Hospital stay OR(1.05, Cl 1.01–1.10), Graft Conduit BIMA vs No Graft OR(10.94,Cl 1.60-74.63), transfusion of both packed cells plus other blood products vs no transfusion OR(3.53, Cl .93-13.44), HbA1c OR(1.09 Cl 0.84–1.41), BMI OR(1.25, Cl 1.04–1.50), perioperative Blood Glucose OR(1.02, Cl 1.004–1.03), surgery time OR(1.19, Cl 1.00-1.58). Conclusions: the diverse aetiology, cross disciplinary nature of SWI prevention, and despite improved prevention and control practices including related care bundles with their proven value, SWI remain a serious challenge in Cardiac Surgery. Multidisciplinary consensus guidelines are well overdue.