Evidence map›Paper›PMID 30416768›Full record

ArticleJournal of thoracic disease2018

Deep sternal infections after in situ bilateral internal thoracic artery grafting for left ventricular myocardial revascularization: predictors and influence on 20-year outcomes.

Massimo Bonacchi, Edvin Prifti, Marco Bugetti, Orlando Parise, Guido Sani, Daniel M Johnson, Francesco Cabrucci, Sandro Gelsomino

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Prevention of Sternal Wound Infections in Women Using an External Sternum Fixation Corset.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2021
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 3 countries.

Massimo BonacchiCardiac Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
Edvin PriftiDivision of Cardiac Surgery, University Hospital Center of Tirana, Tirana, Albania.
Marco BugettiCardiac Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
Orlando PariseCardiovascular Research Institute Maastricht-CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
Guido SaniCardiac Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
Daniel M JohnsonCardiovascular Research Institute Maastricht-CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
Francesco CabrucciCardiac Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
Sandro GelsominoCardiovascular Research Institute Maastricht-CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
University of Florence · ITMaastricht University Medical Centre · NLUniversity of Tirana · AL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe incidence and potential factors influencing deep sternal wound infection (DSWI) in a cohort of patients undergoing coronary artery bypass grafting (CABG) using skeletonized bilateral internal thoracic artery (BITA) was explored. Furthermore, we studied influence of DSWI on long-term survival, major adverse cardiac events (MACEs) and repeat coronary revascularization (RCR).

methodsThe study cohort consisted of 1,325 consecutive patients who were divided in two groups: patients experiencing DSWI (n=33, group 1) and those who did not have sternal infection (n=1,292, group 2). A logistic regression model was employed to find predictors of DSWI whereas Cox regression and a competing risk models were carried out to test predictors of late death, MACE and RCR, respectively. Follow up was 100% complete and ranged from 1 to 245 months. Median follow-up was 103 months (IQR, 61 to 189 months). Cumulative follow-up was 16,430 patient years.

resultsThe incidence of DSWI was 2.4%. Multivariable logistic regression analysis found any single independent predictor of DSWI. However, the association of peripheral vascular disease (PVD) and diabetes increased the risk by 1.4 and 1.6 times. When DM was associated with obesity the risk increased by 2.1 and 2.6 times compared to the single factors, respectively. Obese female patients were at a 1.6-fold higher risk when compared to the association of DM with obesity. DSWI was not an independent predictor of long-term survival (HR, 2.31; 95% CI: 0.59-9.12), RCR (SHR, 2.89; 95% CI: 0.65-10.12), or MACE (SHR, 1.98; 95% CI: 0.44-8.56).

conclusionsWith an accurate patient selection (i.e., exclusion of obese diabetic females) and strict DM control BITA represents a first choice for most of CABG patients, even at high risk for DSWI. The occurrence of DSWI does not influence long-term survival and late outcomes. Our findings should be confirmed by further larger research.

Indexed as

complicationsCoronary artery bypassinternal thoracic arterysternal infection

Identifiers

PMID30416768
PMCPMC6196217
OpenAlexW2892768202

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.