Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study

Abstract. Background. This study aimed to summarize the clinical characteristics of patients with deep sternal wound infection-induced sepsis after median sternotomy and improve the treatment outcomes of infection-related sepsis. Methods. A retrospective cohort study was conducted on 21 patients wit...

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Main Authors: Bin Song, Zhentian Cui, Hongyan Ju, Yue Sun, Dandan Liu, Guanggang Li
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2024-06-01
Series:Emergency and Critical Care Medicine
Online Access:http://journals.lww.com/10.1097/EC9.0000000000000115
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author Bin Song
Zhentian Cui
Hongyan Ju
Yue Sun
Dandan Liu
Guanggang Li
author_facet Bin Song
Zhentian Cui
Hongyan Ju
Yue Sun
Dandan Liu
Guanggang Li
author_sort Bin Song
collection DOAJ
description Abstract. Background. This study aimed to summarize the clinical characteristics of patients with deep sternal wound infection-induced sepsis after median sternotomy and improve the treatment outcomes of infection-related sepsis. Methods. A retrospective cohort study was conducted on 21 patients with deep sternal wound infection-induced sepsis after median sternotomy who were admitted to the Department of Critical Care. The clinical manifestations, laboratory test results, infection control, and organ and nutritional support of the patients were summarized, and the follow-up data were obtained. Results. The primary symptoms of deep sternal wound infection-induced sepsis included dyspnea, high fever, chills, and altered state of consciousness. Laboratory test results revealed increased inflammatory markers and decreased oxygenation index. Renal and liver function injury were observed in 8 and 4 patients, respectively; 18 and 12 patients demonstrated elevated D-dimer and N-terminal Pro B type natriuretic peptide levels, respectively. Of the 8 patients whose wound secretions tested positive for bacteria, Acinetobacter baumannii and Staphylococcus aureus infections were present in 6 and 2 patients, respectively. One of the 6 patients whose blood cultures tested positive for bacteria demonstrated Candida albicans infection. Fifteen patients received ventilator-assisted ventilation and 2 patients received renal replacement therapy. Of all the 21 patients, 17 were cured, 2 died, and 2 were discharged. Conclusion. Postmedian sternotomy sepsis attributed to a deep sternal wound infection usually results from a preexisting condition. The most prominent clinical manifestation is dyspnea, which is sometimes accompanied by the impairment of organ function. Infection prevention, proper nutrition support, and maintenance of healthy organ function are the cornerstones for successful treatment outcomes.
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spelling doaj-art-0af39cd0ea4247aba5450468e76478052025-08-20T02:26:09ZengWolters Kluwer Health/LWWEmergency and Critical Care Medicine2097-06172693-860X2024-06-0142677310.1097/EC9.0000000000000115202406000-00004Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort studyBin Song0Zhentian Cui1Hongyan Ju2Yue Sun3Dandan Liu4Guanggang Li5a Department of Critical Care, 7th Medical Center of Chinese PLA General Hospital, Beijing, Chinab Department of Cardiac and Macrovascular Surgery, 7th Medical Center of Chinese PLA General Hospital, Beijing, China.a Department of Critical Care, 7th Medical Center of Chinese PLA General Hospital, Beijing, Chinaa Department of Critical Care, 7th Medical Center of Chinese PLA General Hospital, Beijing, Chinaa Department of Critical Care, 7th Medical Center of Chinese PLA General Hospital, Beijing, Chinaa Department of Critical Care, 7th Medical Center of Chinese PLA General Hospital, Beijing, ChinaAbstract. Background. This study aimed to summarize the clinical characteristics of patients with deep sternal wound infection-induced sepsis after median sternotomy and improve the treatment outcomes of infection-related sepsis. Methods. A retrospective cohort study was conducted on 21 patients with deep sternal wound infection-induced sepsis after median sternotomy who were admitted to the Department of Critical Care. The clinical manifestations, laboratory test results, infection control, and organ and nutritional support of the patients were summarized, and the follow-up data were obtained. Results. The primary symptoms of deep sternal wound infection-induced sepsis included dyspnea, high fever, chills, and altered state of consciousness. Laboratory test results revealed increased inflammatory markers and decreased oxygenation index. Renal and liver function injury were observed in 8 and 4 patients, respectively; 18 and 12 patients demonstrated elevated D-dimer and N-terminal Pro B type natriuretic peptide levels, respectively. Of the 8 patients whose wound secretions tested positive for bacteria, Acinetobacter baumannii and Staphylococcus aureus infections were present in 6 and 2 patients, respectively. One of the 6 patients whose blood cultures tested positive for bacteria demonstrated Candida albicans infection. Fifteen patients received ventilator-assisted ventilation and 2 patients received renal replacement therapy. Of all the 21 patients, 17 were cured, 2 died, and 2 were discharged. Conclusion. Postmedian sternotomy sepsis attributed to a deep sternal wound infection usually results from a preexisting condition. The most prominent clinical manifestation is dyspnea, which is sometimes accompanied by the impairment of organ function. Infection prevention, proper nutrition support, and maintenance of healthy organ function are the cornerstones for successful treatment outcomes.http://journals.lww.com/10.1097/EC9.0000000000000115
spellingShingle Bin Song
Zhentian Cui
Hongyan Ju
Yue Sun
Dandan Liu
Guanggang Li
Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study
Emergency and Critical Care Medicine
title Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study
title_full Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study
title_fullStr Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study
title_full_unstemmed Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study
title_short Clinical analysis of patients with deep sternal wound infection-induced sepsis: a retrospective cohort study
title_sort clinical analysis of patients with deep sternal wound infection induced sepsis a retrospective cohort study
url http://journals.lww.com/10.1097/EC9.0000000000000115
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