Mediastinitis post-quirúrgica: Estudio caso - control

POST-SURGICAL MEDIASTINITIS. CASE CONTROL STUDYWe report the results of a case-control study of post-surgical mediastinitis,that we conducted for eighteen months. The aim of the study was to detect possiblerisk factors for mediastinal infection after cardiovascular surgery as well as toanalyze related clinical features. Thirty episodes of mediastinal infections over687 consecutive cardiovascular surgeries (4,4%) were registered during a controlperiod of 18 month at Hospital Italiano of Buenos Aires, Argentina. Among allvariables analyzed only the following were significantly associated to mediastinalinfection in the postoperative period: time elapsed at the recovery unit(p < 0.01) total time with catheter placed in the pulmonary artery (p: 0.05)and the rate of postoperative complications (p < 0.01). Six patients withmediastinal infection (20%) had undergone reoperation shortly after mainsurgery compared to only 3 (5%) in the control group (p: 0.05). The associationwith surgical events may be related to post-surgical causation. The presenceof fever, only after 72 hours from surgery, allowed discrimination betweenpatients with and without mediastinal infection. All case patients showedabnormalities in surgical wound, and 28 of these patients (93%) had at leasttwo local signs of infection. Among the 37 types of microorganisms isolatedfrom sternal secretion, 22 (59%) were gram-positive cocci, with