naa a22 4500 510743277 CHVBK 20180411083035.0 cr unu---uuuuu 180411e20130701xx s 000 0 eng 10.1007/s12630-013-9950-6 doi (NATIONALLICENCE)springer-10.1007/s12630-013-9950-6 The association between tracheostomy and sternal wound infection in postoperative cardiac surgery patients [Elektronische Daten] [Louise Sun, Munir Boodhwani, Heather Baer, Bernard McDonald] L'association entre trachéostomie et infection de plaie sternale chez les patients après une chirurgie cardiaque Purpose: To investigate whether tracheostomy increases the risk of sternal wound infection (SWI) post cardiac surgery. Methods: All patients undergoing cardiac surgery via median sternotomy from September 1997 to October 2010 were included in this retrospective observational study. Primary exposure was tracheostomy performed during admission to the cardiac surgical intensive care unit. The primary outcome was SWI during hospital admission. Multivariable logistic regression was used to determine if tracheostomy was an independent predictor of SWI. Restriction and propensity score analyses were then used to assess if tracheostomy is a causal risk factor for SWI. Results: Four hundred and eleven of 18,845 patients (2.2%) were treated with tracheostomy. Incidences of SWI in tracheostomy and non-tracheostomy groups were 19.5% (80/411) and 0.8% (154/18,434), respectively. Using multivariable logistic regression analysis, tracheostomy was found to be an independent predictor of SWI (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.9 to 4.2). In an analysis restricted to respiratory failure patients, tracheostomy was associated with sternal wound infection (OR 3.4; 95% CI 2.4 to 4.9). When the analysis was stratified by the risk of receiving tracheostomy as represented by propensity score (PS), 46 patients (12%) in the intermediate risk category (PS 0.2-0.4) had SWIs (adjusted OR 2.97; 95% CI 1.6 to 5.6), and 52 patients (14%) in the highest risk category (PS>0.4) had SWIs (OR 1.52; 95% CI 0.85 to 2.87). Discussion: Our single-centre observational study of cardiac surgery patients found tracheostomy to be an independent risk factor for SWI. Our analysis showed a robust association when restricted to patients with respiratory failure and after the population was stratified by the propensity to have a tracheostomy. Canadian Anesthesiologists' Society, 2013 Sun Louise Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7, Ottawa, ON, Canada aut Boodhwani Munir Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada aut Baer Heather Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA aut McDonald Bernard Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7, Ottawa, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/7(2013-07-01), 684-691 0832-610X 60:7<684 2013 60 12630 https://doi.org/10.1007/s12630-013-9950-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-9950-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sun Louise Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Boodhwani Munir Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Baer Heather Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- McDonald Bernard Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7, Ottawa, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/7(2013-07-01), 684-691 0832-610X 60:7<684 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer