Risk Factors of Sternal Wound Infection After Coronary Artery Bypass Graft

Overview

The investigators are trying to evaluate the performance of neutrophil and lymphocyte counts as a risk factor of deep sternal wound infection after coronary artery bypass graft surgery.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Retrospective
  • Study Primary Completion Date: December 2014

Detailed Description

Deep sternal wound infection after coronary artery bypass graft is a very dangerous complication as it prolongs hospital stay, increase morbidity and mortality, and increase cost of care. As a risk factor of surgical site infection, risk index reported by NNIS (national nosocomial infection surveillance), Euroscore, or Society of thoracic surgeon risk score are currently used. However, as various performances are reported regarding these index or scoring systems, and many factors are needed for these index or scoring system, there is a need to develop a more simple risk factor with better performance. We focused on the differential blood cell count, as the neutrophil and lymphocyte count are related to the degree of surgical invasion, and inflammatory response. Previous studies reported that the neutrophilia or lymphopenia is related to postoperative infection. Therefore, we are trying to evaluate the performance of preoperative or postoperative the blood cell differential count as a risk factor for sternal wound infection after coronary artery bypass surgery.

Arms, Groups and Cohorts

  • Coronary Artery Bypass Graft Group
    • Those underwent coronary artery bypass graft surgery with median sternotomy in Samsung Medical Center during the period of January 2008 and December 2011.

Clinical Trial Outcome Measures

Primary Measures

  • postoperative surgical wound infection
    • Time Frame: within first week after the end of coronary artery bypass graft surgery
    • postoperative surgical wound infection within first week after the end of coronary artery bypass graft surgery, classified as a superfical or deep sternal wound infection

Secondary Measures

  • preoperative total leukocyte count
    • Time Frame: 1 day before surgery
    • preoperative total leukocyte count
  • preoperative neutrophil count
    • Time Frame: 1 day before surgery
    • preoperative neutrophil count
  • preoperative lymphocyte count
    • Time Frame: 1 day before surgery
    • preoperative lymphocyte count
  • postoperative total leukocyte count
    • Time Frame: 2 hour after the end of surgery
    • postoprative total leukocyte count
  • postoperative neutrophil count
    • Time Frame: 2 hour after the end of surgery
    • postoperative neutrophil count
  • postoperative lymphocyte count
    • Time Frame: 2 hour after the end of surgery
    • postoperative lymphocyte count
  • preoperative NNIS risk index
    • Time Frame: 1 day before surgery
    • preoperative NNIS risk index
  • preoperative EuroScore
    • Time Frame: 1 day before surgery
    • preoperative EuroScore
  • Preoperative STS
    • Time Frame: 1 day before surgery
    • Preoperative STS (Society of Thoracic Surgeons risk score)
  • the incidence of surgical reopen with surgical wound infection
    • Time Frame: within 1 month after surgery
    • the incidence of surgical reopen with surgical wound infection

Participating in This Clinical Trial

Inclusion Criteria

  • Those underwent coronary artery bypass graft surgery with median sternotomy in Samsung Medical Center during the period of January 2008 and December 2011. Exclusion Criteria:

  • Those underwent coronary artery bypass graft surgery with mini-thoracotomy – Those with insufficient study data recognized by electronic medical record

Gender Eligibility: All

Minimum Age: 20 Years

Maximum Age: 90 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Samsung Medical Center
  • Provider of Information About this Clinical Study
    • Principal Investigator: Sangmin M. Lee, Professor – Samsung Medical Center
  • Overall Official(s)
    • Sangmin M. Lee, MD, PhD, Principal Investigator, Samsung Medical Center
    • Won Ho Kim, MD, PhD, Principal Investigator, Samsung Medical Center
  • Overall Contact(s)
    • Sangmin M. Lee, MD, PhD, 82-2-3410-0362, sangminm.lee@samsung.com

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