Post-Surgical Mediastinitis Within the CHU Brugmann Hospital

Study Overview
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Brief Summary
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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.

Official Title
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Post-Surgical Mediastinitis: Retrospective Study of Cases Treated Within the CHU Brugmann Hospital

Conditions
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Mediastinitis

Intervention / Treatment
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* Other: Data extraction from medical files


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: post-cardiac surgery mediastinitis patients of the CHU Brugmann (adults) and HUDERF (pediatric) Hospitals Exclusion Criteria: - none
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pediatric population<br>Infants diagnosed with cardiac post-surgery mediastinitis within the HUDERF Hospital within the last 20 years. | Other: Data extraction from medical files<br>* Data extraction from medical files<br>|
| Adult population<br>Adults diagnosed with cardiac post-surgery mediastinitis within the CHU Brugmann Hospital within the last 20 years. | Other: Data extraction from medical files<br>* Data extraction from medical files<br>|

What is the study measuring?
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Primary Outcome Measures

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

Secondary Outcome Measures

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