AND RELEVANCE In a broad review of published literature , risk factors for SSI were characterized as describing reduced fitness , patient frailty , surgery duration , and complexity .
IMPORTANCE Surgical site infection ( SSI ) complicates 2 - 5 % of surgeries in the United States .
Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis , and SSIs are responsible for increased morbidity , mortality , and economic burden associated with surgery .
Staphylococcus aureus ( S. aureus ) is a commonly-isolated organism for SSI , and methicillin-resistant S. aureus SSI incidence is increasing globally .
OBJECTIVE The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting .
Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality
Background Sternal wound infection ( SWI ) is an uncommon but potentially life-threatening complication of cardiac surgery . Predisposing factors for SWI are multiple with varied frequencies in different studies . The purpose of this study was to assess the incidence , risk factors , and mortality of SWI after  coronary artery bypass grafting ( CABG ) at Tehran Heart Center . Methods This study prospect ively evaluated multiple risk factors for SWI  in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006 . Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention . Deep SWI ( bone and mediastinitis ) was categorized according to the Oakley classification . Results In the study period , 9201 CABGs were performed with a total SWI rate of 0.47 percent ( 44 cases ) and deep SWI of 0.22 percent ( 21 cases ) . Perioperative ( in-hospital ) mortality was 9.1 % for total SWI and about 14 % for deep SWI versus 1.1 % for non-SWI CABG patients . Female gender , preoperative hypertension , high functional class , diabetes mellitus , obesity , prolonged intubation time ( more than 48 h ) , and re-exploration for bleeding were significant risk factors for developing SWI ( p = 0.05 ) in univariate analysis . In multivariate analysis , hypertension ( OR = 10.7 ) , re-exploration ( OR = 13.4 ) , and female gender ( OR = 2.7 ) were identified as significant predictors of SWI ( p < 0.05 for all ) . The rate of SWI was relatively similar in 3 groups of prophylactic antibiotic regimen ( Cefazolin , Cefazolin + Gentamycin and Cefazolin + Amikacin : 0.5 % , 0.5 % , and 0.34 % respectively ) . Conclusion Rarely reported previously , the two risk factors of hypertension and the female gender were significant risk factors in our study . Conversely , some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study . Further studies are needed for better documentation
AND RELEVANCE In a broad review of published literature , risk factors for SSI were characterized as describing reduced fitness , patient frailty , surgery duration , and complexity .
IMPORTANCE Surgical site infection ( SSI ) complicates 2 - 5 % of surgeries in the United States .
Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis , and SSIs are responsible for increased morbidity , mortality , and economic burden associated with surgery .
Staphylococcus aureus ( S. aureus ) is a commonly-isolated organism for SSI , and methicillin-resistant S. aureus SSI incidence is increasing globally .
OBJECTIVE The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting .