A Prospective Multi-Institutional Cohort Study of Mediastinal Infections After Cardiac Operations

The authors participated in a multi-institutional prospective study to evaluate the frequency, risk factors, and outcomes of patients who suffer mediastinal infection after cardiac surgery.  A total of 5,158 patients were enrolled, and there were 43 infections in 41 patients (0.79 cumulative incidence) occurring at a median time of 20 days after surgery.  The authors discovered the following risk factors for the development of mediastinitis: 

• higher body mass index
• higher creatinine
• peripheral vascular disease
• preoperative steroids
• ventricular assist device or transplant surgery
• postoperative hyperglycemia in nondiabetics

Readmission rates and mortality were five times higher in patients who developed mediastinitis.