Clinical trial NCT03922191: Post-Surgical Mediastinitis Within the CHU Brugmann Hospital
Official title: Post-Surgical Mediastinitis: Retrospective Study of Cases Treated Within the CHU Brugmann Hospital
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Mediastinitis
Lead sponsor: Brugmann University Hospital
Sponsor class: OTHER
First posted: 2019-04-19
Enrollment: 19
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients of the CHU Brugmann (adults) and HUDERF (pediatric) Hospitals, treated for post-cardiac surgery mediastinitis.

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.


Eligibility criteria: Inclusion Criteria:

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

Exclusion Criteria:

- none

Primary outcomes:
measure: Duration of the hospitalization
timeFrame: 20 years
measure: Mortality at six months
timeFrame: 6 months
measure: Percentage of recurrence
timeFrame: 20 years
measure: Percentage of re-hospitalization
timeFrame: 20 years
measure: Duration of the antibiotic treatment
timeFrame: 20 years
measure: Presence of superinfection
timeFrame: 20 years
Secondary outcomes:
measure: Date of birth
timeFrame: 20 years
measure: Sex
timeFrame: 20 years
measure: Risk factors
timeFrame: 20 years
measure: Surgical intervention
timeFrame: 20 years
measure: Germ identification
timeFrame: 20 years
measure: Type of treatment
timeFrame: 20 years
Other outcomes:
Locations:
city: Brussels
country: Belgium
facility: CHU Brugmann
Study officials:
affiliation: CHU Brugmann
name: Laura Pauels, MD
role: PRINCIPAL_INVESTIGATOR
References: