Post-Surgical Mediastinitis Within the CHU Brugmann Hospital

Completed

• Conditions: Mediastinitis
• Interventions: Other: Data extraction from medical files

• Registration Number: NCT03922191
• Lead Sponsor: Pierre Wauthy

Brief Summary

Mediastinitis is an infectious complication that can occur after cardiac surgery. The incidence varies between 1 and 3% depending on the type of procedure and the patient's condition. The mortality of this severe postoperative complication rises from 10 to 35%, which makes it dreadful.

The major risk factors reported are obesity, diabetes, and immunosuppressive therapy. There are other less important ones: age, coronary bypass grafting (especially if using the two internal mammary arteries), nosocomial pneumonia, dialysis, prolonged mechanical ventilation, long operative asepsis, undrained retro-sternally hematoma, prolonged pre-operative hospitalization...).

Prevention is very important. The principle of asepsis must absolutely be respected. The use of prophylactic antibiotic therapy is recommended.

The most commonly encountered organisms are Staphylococcus aureus, coagulase-negative Staphylococci and gram-negative bacilli.

There are several treatment modalities that vary between centers and may be different depending on the surgical team's experience and the depth or extent of the infection. The common principles of these treatments are: antibiotic therapy and surgical debridement (the timing of which may vary). The timing and modalities of wound closure are subject to variations: immediate sternal closure with placement of multiple or delayed drains. Muscle flaps or large omentum transplant may be necessary if tissue loss is too important.

The investigators propose to review their experience in the treatment of cardiac post-surgery mediastinitis at Brugmann University Hospital in the last 20 years in both adult and pediatric patients.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-02-12
• Study First Submitted: 2019-04-17
• Study First Submitted QC: 2019-04-18
• Study First Posted: 2019-04-19
• Status Verified: 2019-07
• Primary Completion: 2019-07-15
• Study Completion: 2019-07-15
• Last Update Submitted: 2019-07-15
• Last Update Posted: 2019-07-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 19

Inclusion Criteria

• post-cardiac surgery mediastinitis
• patients of the CHU Brugmann (adults) and HUDERF (pediatric) Hospitals

Exclusion Criteria

• none

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Pediatric population	Data extraction from medical files	Infants diagnosed with cardiac post-surgery mediastinitis within the HUDERF Hospital within the last 20 years.
Adult population	Data extraction from medical files	Adults diagnosed with cardiac post-surgery mediastinitis within the CHU Brugmann Hospital within the last 20 years.

Primary Outcome Measures

Name	Time	Method
Duration of the antibiotic treatment	20 years	Duration of the antibiotic treatment for mediastinitis
Duration of the hospitalization	20 years	Duration of the hospitalization
Mortality at six months	6 months	Mortality rate six months after mediastinitis diagnosis
Presence of superinfection	20 years	Presence of superinfection
Percentage of recurrence	20 years	Percentage of recurrence of mediastinitis
Percentage of re-hospitalization	20 years	Percentage of re-hospitalizations caused by mediastinitis

Secondary Outcome Measures

Name	Time	Method
Risk factors	20 years	Demographic data : presence of risk factors (obesity, diabetes...).
Type of treatment	20 years	Name of the antibiotics used to treat the mediastinitis
Date of birth	20 years	Demographic data : Date of birth.
Surgical intervention	20 years	Name of the surgical intervention that caused the mediastinitis
Germ identification	20 years	Name of the germ causing the mediastinitis
Sex	20 years	Demographic data : sex.

Trial Locations

Locations (1)

CHU Brugmann; 🇧🇪 Brussels, Belgium