| Characteristic . | Patients, No. (%)a . | P Value . | |||
|---|---|---|---|---|---|
| All Mediastinitis (N = 151) . | PSM (n = 63 [41.7%]) . | MEP (n = 60 [39.7%]) . | DNM (n = 17 [11.3%]) . | ||
| Demographics | |||||
| Age, mean (SD), y | 63.3 (14.5) | 64.9 (11.8) | 65.6 (12.6) | 46.3 (18) | .002b |
| Male sex | 109 (72.2) | 45 (71.4) | 40 (66.7) | 14 (82.4) | .33 |
| BMI, mean (SD)c | 27 (5.7) | 29.6 (5.9) | 24.4 (3.7) | 26.2 (6) | <.001b |
| Obesity (BMI >30)c | 31 (20.5) | 24 (38.1) | 4 (6.7) | 3 (17.6) | |
| Chronic renal failure | 19 (12.6) | 14 (22.2) | 5 (8.3) | 0 (0) | .02b |
| Cardiovascular comorbid conditions | |||||
| Total no., mean (SD) | 2.4 (2) | 3.8 (1.9) | 1.5 (1.5) | 1 (1.5) | <.001b |
| High blood pressure | 78 (51.7) | 46 (73.0) | 25 (41.7) | 3 (17.6) | <.001b |
| Diabetes | 56 (37.1) | 39 (61.9) | 12 (20.0) | 3 (17.6) | <.001b |
| Dyslipidemia | 62 (41.1) | 42 (66.7) | 14 (23.3) | 4 (23.5) | <.001b |
| Coronary heart disease | 51 (33.8) | 45 (71.4) | 5 (8.3) | 1 (5.9) | <.001b |
| Lower-extremity artery disease | 22 (14.6) | 15 (23.8) | 6 (10.0) | 1 (5.9) | .06 |
| Valvular disease | 22 (14.6) | 18 (28.6) | 4 (6.7) | 0 (0) | <.001b |
| Valvular prosthesis | 16 (10.6) | 14 (22.2) | 1 (1.7) | 0 (0) | <.001b |
| Cardiac implantable device | 7 (4.6) | 6 (9.5) | 0 (0) | 0 (0) | .04b |
| History of neoplasia | 46 (30.4) | 9 (14.3) | 33 (55.0) | 1 (5.9) | <.001b |
| Immunosuppression | 29 (19.2) | 8 (12.7) | 18 (30.0) | 0 (0) | .008b |
| Immunosuppressive therapy | 9 (6.0) | 6 (9.5) | 1 (1.7) | … | … |
| Recent chemotherapy | 19 (12.6) | 2 (3.2) | 16 (26.7) | … | … |
| Solid organ transplantation | 7 (4.6) | 5 (7.9) | 0 (0) | … | … |
| No known comorbid conditions | 19 (12.6) | 3 (4.8) | 7 (11.7) | 9 (52.9) | <.001b |
| Surgical history before mediastinitis | |||||
| Surgery within 1 y | 105 (69.5) | 61 (96.8) | 38 (63.3) | 1 (5.9) | <.001b |
| Cardiovascular surgery | 60 (57.1) | 58 (95.1) | 0 (0) | 0 (0) | … |
| Coronary graft | 29 (48.3) | 29 (50.0) | … | … | … |
| Valvular surgery | 19 (31.7) | 18 (31.0) | … | … | … |
| Otherd | 12 (20.0) | 11 (19.1) | … | … | … |
| Gastroesophageal surgery/procedure | 36 (34.3) | 0 (0) | 36 (94.7) | 0 (0) | … |
| Lewis-Santy procedure | 17 (47.2) | … | 17 (47.2) | … | … |
| Esophageal dilation | 7 (19.4) | … | 7 (19.4) | … | … |
| Othere | 12 (33.3) | … | 12 (33.3) | … | … |
| Surgical revision before mediastinitis | 17 (16.2) | 6 (9.8) | 9 (23.7) | 0 (0) | .10 |
| Time between initial surgery and mediastinitis, median, d | 11 (5–23) | 16 (10–28) | 5 (1–11) | 1 | … |
| Clinical and radiological data | |||||
| Fever | 110 (72.8) | 45 (71.4) | 35 (63.3) | 17 (100) | .005b |
| Chest pain | 55 (38.7) | 23 (38.3) | 22 (40.0) | 7 (41.2) | .94 |
| Sternal scar abnormalities | 48 (31.8) | 46 (73.0) | 0 (0) | 0 (0) | <.001b |
| Septic shock | 68 (45.0) | 21 (33.3) | 40 (66.7) | 3 (17.6) | <.001b |
| Chest CT performed | 138 (91.4) | 52 (82.5) | 59 (98.3) | 17 (100) | .007b |
| Chest CT contributory to diagnosis | 132/138 (95.7) | 47/52 (90.4) | 58/59 (98.3) | 17/17 (100) | .20 |
| Management | |||||
| Surgery for mediastinitis | 122 (80.8) | 58 (92.1) | 45 (75.0) | 13 (76.5) | .006b |
| Time between diagnosis and surgery, median, d | 1 (0–5) | 2 (0–8) | 0 (0–3) | 3 (0–4) | .80 |
| Perioperative evidence of mediastinitis | 99 (81.1) | 52 (89.7) | 31 (68.9) | 11 (84.6) | .052 |
| Surgical revision for mediastinitis | 38 (31.1) | 20 (34.5) | 9 (20.0) | 7 (53.4) | .10 |
| Duration of intravenous antimicrobial therapy, median, d | 32 (15–50) | 42 (20–52) | 28 (14–47) | 22 (17–34) | .42 |
| Switch to oral antimicrobial therapy | 28 (20.1) | 16 (25.4) | 5 (9.8) | 5 (33.3) | .08 |
| Total duration of antimicrobial therapy, median, d | 41 (21–56) | 49 (40–63) | 28 (15–49) | 30 (20–38) | .30 |
| Prognosis | |||||
| Length of hospital stay, median, d | 32 (21–59) | 34 (21–53) | 33 (25–64) | 25 (12–35) | .71 |
| ICU hospitalization | 129 (85.4) | 52 (82.5) | 55 (91.7) | 13 (76.5) | .24 |
| Length of ICU stay, median, d | 6 (2–18) | 4 (1–9) | 8 (4–24) | 13 (5–23) | .42 |
| All-cause mortality | 50 (33.1) | 21 (33.3) | 19 (31.7) | 2 (11.8) | .01b |
| In-hospital mortality | 36 (23.8) | 14 (22.2) | 14 (23.3) | 1 (5.9) | .01b |
| Time between inclusion and death, median, d | 32 (21–59) | 49 (19–201) | 28 (9–84) | 41 (38–43) | .28 |
| Characteristic . | Patients, No. (%)a . | P Value . | |||
|---|---|---|---|---|---|
| All Mediastinitis (N = 151) . | PSM (n = 63 [41.7%]) . | MEP (n = 60 [39.7%]) . | DNM (n = 17 [11.3%]) . | ||
| Demographics | |||||
| Age, mean (SD), y | 63.3 (14.5) | 64.9 (11.8) | 65.6 (12.6) | 46.3 (18) | .002b |
| Male sex | 109 (72.2) | 45 (71.4) | 40 (66.7) | 14 (82.4) | .33 |
| BMI, mean (SD)c | 27 (5.7) | 29.6 (5.9) | 24.4 (3.7) | 26.2 (6) | <.001b |
| Obesity (BMI >30)c | 31 (20.5) | 24 (38.1) | 4 (6.7) | 3 (17.6) | |
| Chronic renal failure | 19 (12.6) | 14 (22.2) | 5 (8.3) | 0 (0) | .02b |
| Cardiovascular comorbid conditions | |||||
| Total no., mean (SD) | 2.4 (2) | 3.8 (1.9) | 1.5 (1.5) | 1 (1.5) | <.001b |
| High blood pressure | 78 (51.7) | 46 (73.0) | 25 (41.7) | 3 (17.6) | <.001b |
| Diabetes | 56 (37.1) | 39 (61.9) | 12 (20.0) | 3 (17.6) | <.001b |
| Dyslipidemia | 62 (41.1) | 42 (66.7) | 14 (23.3) | 4 (23.5) | <.001b |
| Coronary heart disease | 51 (33.8) | 45 (71.4) | 5 (8.3) | 1 (5.9) | <.001b |
| Lower-extremity artery disease | 22 (14.6) | 15 (23.8) | 6 (10.0) | 1 (5.9) | .06 |
| Valvular disease | 22 (14.6) | 18 (28.6) | 4 (6.7) | 0 (0) | <.001b |
| Valvular prosthesis | 16 (10.6) | 14 (22.2) | 1 (1.7) | 0 (0) | <.001b |
| Cardiac implantable device | 7 (4.6) | 6 (9.5) | 0 (0) | 0 (0) | .04b |
| History of neoplasia | 46 (30.4) | 9 (14.3) | 33 (55.0) | 1 (5.9) | <.001b |
| Immunosuppression | 29 (19.2) | 8 (12.7) | 18 (30.0) | 0 (0) | .008b |
| Immunosuppressive therapy | 9 (6.0) | 6 (9.5) | 1 (1.7) | … | … |
| Recent chemotherapy | 19 (12.6) | 2 (3.2) | 16 (26.7) | … | … |
| Solid organ transplantation | 7 (4.6) | 5 (7.9) | 0 (0) | … | … |
| No known comorbid conditions | 19 (12.6) | 3 (4.8) | 7 (11.7) | 9 (52.9) | <.001b |
| Surgical history before mediastinitis | |||||
| Surgery within 1 y | 105 (69.5) | 61 (96.8) | 38 (63.3) | 1 (5.9) | <.001b |
| Cardiovascular surgery | 60 (57.1) | 58 (95.1) | 0 (0) | 0 (0) | … |
| Coronary graft | 29 (48.3) | 29 (50.0) | … | … | … |
| Valvular surgery | 19 (31.7) | 18 (31.0) | … | … | … |
| Otherd | 12 (20.0) | 11 (19.1) | … | … | … |
| Gastroesophageal surgery/procedure | 36 (34.3) | 0 (0) | 36 (94.7) | 0 (0) | … |
| Lewis-Santy procedure | 17 (47.2) | … | 17 (47.2) | … | … |
| Esophageal dilation | 7 (19.4) | … | 7 (19.4) | … | … |
| Othere | 12 (33.3) | … | 12 (33.3) | … | … |
| Surgical revision before mediastinitis | 17 (16.2) | 6 (9.8) | 9 (23.7) | 0 (0) | .10 |
| Time between initial surgery and mediastinitis, median, d | 11 (5–23) | 16 (10–28) | 5 (1–11) | 1 | … |
| Clinical and radiological data | |||||
| Fever | 110 (72.8) | 45 (71.4) | 35 (63.3) | 17 (100) | .005b |
| Chest pain | 55 (38.7) | 23 (38.3) | 22 (40.0) | 7 (41.2) | .94 |
| Sternal scar abnormalities | 48 (31.8) | 46 (73.0) | 0 (0) | 0 (0) | <.001b |
| Septic shock | 68 (45.0) | 21 (33.3) | 40 (66.7) | 3 (17.6) | <.001b |
| Chest CT performed | 138 (91.4) | 52 (82.5) | 59 (98.3) | 17 (100) | .007b |
| Chest CT contributory to diagnosis | 132/138 (95.7) | 47/52 (90.4) | 58/59 (98.3) | 17/17 (100) | .20 |
| Management | |||||
| Surgery for mediastinitis | 122 (80.8) | 58 (92.1) | 45 (75.0) | 13 (76.5) | .006b |
| Time between diagnosis and surgery, median, d | 1 (0–5) | 2 (0–8) | 0 (0–3) | 3 (0–4) | .80 |
| Perioperative evidence of mediastinitis | 99 (81.1) | 52 (89.7) | 31 (68.9) | 11 (84.6) | .052 |
| Surgical revision for mediastinitis | 38 (31.1) | 20 (34.5) | 9 (20.0) | 7 (53.4) | .10 |
| Duration of intravenous antimicrobial therapy, median, d | 32 (15–50) | 42 (20–52) | 28 (14–47) | 22 (17–34) | .42 |
| Switch to oral antimicrobial therapy | 28 (20.1) | 16 (25.4) | 5 (9.8) | 5 (33.3) | .08 |
| Total duration of antimicrobial therapy, median, d | 41 (21–56) | 49 (40–63) | 28 (15–49) | 30 (20–38) | .30 |
| Prognosis | |||||
| Length of hospital stay, median, d | 32 (21–59) | 34 (21–53) | 33 (25–64) | 25 (12–35) | .71 |
| ICU hospitalization | 129 (85.4) | 52 (82.5) | 55 (91.7) | 13 (76.5) | .24 |
| Length of ICU stay, median, d | 6 (2–18) | 4 (1–9) | 8 (4–24) | 13 (5–23) | .42 |
| All-cause mortality | 50 (33.1) | 21 (33.3) | 19 (31.7) | 2 (11.8) | .01b |
| In-hospital mortality | 36 (23.8) | 14 (22.2) | 14 (23.3) | 1 (5.9) | .01b |
| Time between inclusion and death, median, d | 32 (21–59) | 49 (19–201) | 28 (9–84) | 41 (38–43) | .28 |
Abbreviations: BMI, body mass index; CT, computed tomography; DNM, descending necrotizing mediastinitis; ICU, intensive care unit; MEP, mediastinitis due to esophageal perforation; PSM, poststernotomy mediastinitis; SD, standard deviation.
aData represent no. (%) of patients unless otherwise specified.
bSignificant at P < .05.
cBMI calculated as weight in kilograms divided by height in meters squared.
dOther cardiovascular surgery included aortic surgery (8 of 60 patients), cardiac graft (3 of 60), and electronic cardiac device implantation (1 of 60);
eOther gastroesophageal procedures included hiatal hernia repair (4 of 36 patients); esophageal diverticulum surgery (3 of 36); and stomach ulcer suture, complicated ultrasonography-endoscopy, complicated transesophageal echocardiography, surgery for spontaneous rupture of the esophagus, and cervical corpectomy complicated by an esophageal fistula (each 1 of 36).
| Characteristic . | Patients, No. (%)a . | P Value . | |||
|---|---|---|---|---|---|
| All Mediastinitis (N = 151) . | PSM (n = 63 [41.7%]) . | MEP (n = 60 [39.7%]) . | DNM (n = 17 [11.3%]) . | ||
| Demographics | |||||
| Age, mean (SD), y | 63.3 (14.5) | 64.9 (11.8) | 65.6 (12.6) | 46.3 (18) | .002b |
| Male sex | 109 (72.2) | 45 (71.4) | 40 (66.7) | 14 (82.4) | .33 |
| BMI, mean (SD)c | 27 (5.7) | 29.6 (5.9) | 24.4 (3.7) | 26.2 (6) | <.001b |
| Obesity (BMI >30)c | 31 (20.5) | 24 (38.1) | 4 (6.7) | 3 (17.6) | |
| Chronic renal failure | 19 (12.6) | 14 (22.2) | 5 (8.3) | 0 (0) | .02b |
| Cardiovascular comorbid conditions | |||||
| Total no., mean (SD) | 2.4 (2) | 3.8 (1.9) | 1.5 (1.5) | 1 (1.5) | <.001b |
| High blood pressure | 78 (51.7) | 46 (73.0) | 25 (41.7) | 3 (17.6) | <.001b |
| Diabetes | 56 (37.1) | 39 (61.9) | 12 (20.0) | 3 (17.6) | <.001b |
| Dyslipidemia | 62 (41.1) | 42 (66.7) | 14 (23.3) | 4 (23.5) | <.001b |
| Coronary heart disease | 51 (33.8) | 45 (71.4) | 5 (8.3) | 1 (5.9) | <.001b |
| Lower-extremity artery disease | 22 (14.6) | 15 (23.8) | 6 (10.0) | 1 (5.9) | .06 |
| Valvular disease | 22 (14.6) | 18 (28.6) | 4 (6.7) | 0 (0) | <.001b |
| Valvular prosthesis | 16 (10.6) | 14 (22.2) | 1 (1.7) | 0 (0) | <.001b |
| Cardiac implantable device | 7 (4.6) | 6 (9.5) | 0 (0) | 0 (0) | .04b |
| History of neoplasia | 46 (30.4) | 9 (14.3) | 33 (55.0) | 1 (5.9) | <.001b |
| Immunosuppression | 29 (19.2) | 8 (12.7) | 18 (30.0) | 0 (0) | .008b |
| Immunosuppressive therapy | 9 (6.0) | 6 (9.5) | 1 (1.7) | … | … |
| Recent chemotherapy | 19 (12.6) | 2 (3.2) | 16 (26.7) | … | … |
| Solid organ transplantation | 7 (4.6) | 5 (7.9) | 0 (0) | … | … |
| No known comorbid conditions | 19 (12.6) | 3 (4.8) | 7 (11.7) | 9 (52.9) | <.001b |
| Surgical history before mediastinitis | |||||
| Surgery within 1 y | 105 (69.5) | 61 (96.8) | 38 (63.3) | 1 (5.9) | <.001b |
| Cardiovascular surgery | 60 (57.1) | 58 (95.1) | 0 (0) | 0 (0) | … |
| Coronary graft | 29 (48.3) | 29 (50.0) | … | … | … |
| Valvular surgery | 19 (31.7) | 18 (31.0) | … | … | … |
| Otherd | 12 (20.0) | 11 (19.1) | … | … | … |
| Gastroesophageal surgery/procedure | 36 (34.3) | 0 (0) | 36 (94.7) | 0 (0) | … |
| Lewis-Santy procedure | 17 (47.2) | … | 17 (47.2) | … | … |
| Esophageal dilation | 7 (19.4) | … | 7 (19.4) | … | … |
| Othere | 12 (33.3) | … | 12 (33.3) | … | … |
| Surgical revision before mediastinitis | 17 (16.2) | 6 (9.8) | 9 (23.7) | 0 (0) | .10 |
| Time between initial surgery and mediastinitis, median, d | 11 (5–23) | 16 (10–28) | 5 (1–11) | 1 | … |
| Clinical and radiological data | |||||
| Fever | 110 (72.8) | 45 (71.4) | 35 (63.3) | 17 (100) | .005b |
| Chest pain | 55 (38.7) | 23 (38.3) | 22 (40.0) | 7 (41.2) | .94 |
| Sternal scar abnormalities | 48 (31.8) | 46 (73.0) | 0 (0) | 0 (0) | <.001b |
| Septic shock | 68 (45.0) | 21 (33.3) | 40 (66.7) | 3 (17.6) | <.001b |
| Chest CT performed | 138 (91.4) | 52 (82.5) | 59 (98.3) | 17 (100) | .007b |
| Chest CT contributory to diagnosis | 132/138 (95.7) | 47/52 (90.4) | 58/59 (98.3) | 17/17 (100) | .20 |
| Management | |||||
| Surgery for mediastinitis | 122 (80.8) | 58 (92.1) | 45 (75.0) | 13 (76.5) | .006b |
| Time between diagnosis and surgery, median, d | 1 (0–5) | 2 (0–8) | 0 (0–3) | 3 (0–4) | .80 |
| Perioperative evidence of mediastinitis | 99 (81.1) | 52 (89.7) | 31 (68.9) | 11 (84.6) | .052 |
| Surgical revision for mediastinitis | 38 (31.1) | 20 (34.5) | 9 (20.0) | 7 (53.4) | .10 |
| Duration of intravenous antimicrobial therapy, median, d | 32 (15–50) | 42 (20–52) | 28 (14–47) | 22 (17–34) | .42 |
| Switch to oral antimicrobial therapy | 28 (20.1) | 16 (25.4) | 5 (9.8) | 5 (33.3) | .08 |
| Total duration of antimicrobial therapy, median, d | 41 (21–56) | 49 (40–63) | 28 (15–49) | 30 (20–38) | .30 |
| Prognosis | |||||
| Length of hospital stay, median, d | 32 (21–59) | 34 (21–53) | 33 (25–64) | 25 (12–35) | .71 |
| ICU hospitalization | 129 (85.4) | 52 (82.5) | 55 (91.7) | 13 (76.5) | .24 |
| Length of ICU stay, median, d | 6 (2–18) | 4 (1–9) | 8 (4–24) | 13 (5–23) | .42 |
| All-cause mortality | 50 (33.1) | 21 (33.3) | 19 (31.7) | 2 (11.8) | .01b |
| In-hospital mortality | 36 (23.8) | 14 (22.2) | 14 (23.3) | 1 (5.9) | .01b |
| Time between inclusion and death, median, d | 32 (21–59) | 49 (19–201) | 28 (9–84) | 41 (38–43) | .28 |
| Characteristic . | Patients, No. (%)a . | P Value . | |||
|---|---|---|---|---|---|
| All Mediastinitis (N = 151) . | PSM (n = 63 [41.7%]) . | MEP (n = 60 [39.7%]) . | DNM (n = 17 [11.3%]) . | ||
| Demographics | |||||
| Age, mean (SD), y | 63.3 (14.5) | 64.9 (11.8) | 65.6 (12.6) | 46.3 (18) | .002b |
| Male sex | 109 (72.2) | 45 (71.4) | 40 (66.7) | 14 (82.4) | .33 |
| BMI, mean (SD)c | 27 (5.7) | 29.6 (5.9) | 24.4 (3.7) | 26.2 (6) | <.001b |
| Obesity (BMI >30)c | 31 (20.5) | 24 (38.1) | 4 (6.7) | 3 (17.6) | |
| Chronic renal failure | 19 (12.6) | 14 (22.2) | 5 (8.3) | 0 (0) | .02b |
| Cardiovascular comorbid conditions | |||||
| Total no., mean (SD) | 2.4 (2) | 3.8 (1.9) | 1.5 (1.5) | 1 (1.5) | <.001b |
| High blood pressure | 78 (51.7) | 46 (73.0) | 25 (41.7) | 3 (17.6) | <.001b |
| Diabetes | 56 (37.1) | 39 (61.9) | 12 (20.0) | 3 (17.6) | <.001b |
| Dyslipidemia | 62 (41.1) | 42 (66.7) | 14 (23.3) | 4 (23.5) | <.001b |
| Coronary heart disease | 51 (33.8) | 45 (71.4) | 5 (8.3) | 1 (5.9) | <.001b |
| Lower-extremity artery disease | 22 (14.6) | 15 (23.8) | 6 (10.0) | 1 (5.9) | .06 |
| Valvular disease | 22 (14.6) | 18 (28.6) | 4 (6.7) | 0 (0) | <.001b |
| Valvular prosthesis | 16 (10.6) | 14 (22.2) | 1 (1.7) | 0 (0) | <.001b |
| Cardiac implantable device | 7 (4.6) | 6 (9.5) | 0 (0) | 0 (0) | .04b |
| History of neoplasia | 46 (30.4) | 9 (14.3) | 33 (55.0) | 1 (5.9) | <.001b |
| Immunosuppression | 29 (19.2) | 8 (12.7) | 18 (30.0) | 0 (0) | .008b |
| Immunosuppressive therapy | 9 (6.0) | 6 (9.5) | 1 (1.7) | … | … |
| Recent chemotherapy | 19 (12.6) | 2 (3.2) | 16 (26.7) | … | … |
| Solid organ transplantation | 7 (4.6) | 5 (7.9) | 0 (0) | … | … |
| No known comorbid conditions | 19 (12.6) | 3 (4.8) | 7 (11.7) | 9 (52.9) | <.001b |
| Surgical history before mediastinitis | |||||
| Surgery within 1 y | 105 (69.5) | 61 (96.8) | 38 (63.3) | 1 (5.9) | <.001b |
| Cardiovascular surgery | 60 (57.1) | 58 (95.1) | 0 (0) | 0 (0) | … |
| Coronary graft | 29 (48.3) | 29 (50.0) | … | … | … |
| Valvular surgery | 19 (31.7) | 18 (31.0) | … | … | … |
| Otherd | 12 (20.0) | 11 (19.1) | … | … | … |
| Gastroesophageal surgery/procedure | 36 (34.3) | 0 (0) | 36 (94.7) | 0 (0) | … |
| Lewis-Santy procedure | 17 (47.2) | … | 17 (47.2) | … | … |
| Esophageal dilation | 7 (19.4) | … | 7 (19.4) | … | … |
| Othere | 12 (33.3) | … | 12 (33.3) | … | … |
| Surgical revision before mediastinitis | 17 (16.2) | 6 (9.8) | 9 (23.7) | 0 (0) | .10 |
| Time between initial surgery and mediastinitis, median, d | 11 (5–23) | 16 (10–28) | 5 (1–11) | 1 | … |
| Clinical and radiological data | |||||
| Fever | 110 (72.8) | 45 (71.4) | 35 (63.3) | 17 (100) | .005b |
| Chest pain | 55 (38.7) | 23 (38.3) | 22 (40.0) | 7 (41.2) | .94 |
| Sternal scar abnormalities | 48 (31.8) | 46 (73.0) | 0 (0) | 0 (0) | <.001b |
| Septic shock | 68 (45.0) | 21 (33.3) | 40 (66.7) | 3 (17.6) | <.001b |
| Chest CT performed | 138 (91.4) | 52 (82.5) | 59 (98.3) | 17 (100) | .007b |
| Chest CT contributory to diagnosis | 132/138 (95.7) | 47/52 (90.4) | 58/59 (98.3) | 17/17 (100) | .20 |
| Management | |||||
| Surgery for mediastinitis | 122 (80.8) | 58 (92.1) | 45 (75.0) | 13 (76.5) | .006b |
| Time between diagnosis and surgery, median, d | 1 (0–5) | 2 (0–8) | 0 (0–3) | 3 (0–4) | .80 |
| Perioperative evidence of mediastinitis | 99 (81.1) | 52 (89.7) | 31 (68.9) | 11 (84.6) | .052 |
| Surgical revision for mediastinitis | 38 (31.1) | 20 (34.5) | 9 (20.0) | 7 (53.4) | .10 |
| Duration of intravenous antimicrobial therapy, median, d | 32 (15–50) | 42 (20–52) | 28 (14–47) | 22 (17–34) | .42 |
| Switch to oral antimicrobial therapy | 28 (20.1) | 16 (25.4) | 5 (9.8) | 5 (33.3) | .08 |
| Total duration of antimicrobial therapy, median, d | 41 (21–56) | 49 (40–63) | 28 (15–49) | 30 (20–38) | .30 |
| Prognosis | |||||
| Length of hospital stay, median, d | 32 (21–59) | 34 (21–53) | 33 (25–64) | 25 (12–35) | .71 |
| ICU hospitalization | 129 (85.4) | 52 (82.5) | 55 (91.7) | 13 (76.5) | .24 |
| Length of ICU stay, median, d | 6 (2–18) | 4 (1–9) | 8 (4–24) | 13 (5–23) | .42 |
| All-cause mortality | 50 (33.1) | 21 (33.3) | 19 (31.7) | 2 (11.8) | .01b |
| In-hospital mortality | 36 (23.8) | 14 (22.2) | 14 (23.3) | 1 (5.9) | .01b |
| Time between inclusion and death, median, d | 32 (21–59) | 49 (19–201) | 28 (9–84) | 41 (38–43) | .28 |
Abbreviations: BMI, body mass index; CT, computed tomography; DNM, descending necrotizing mediastinitis; ICU, intensive care unit; MEP, mediastinitis due to esophageal perforation; PSM, poststernotomy mediastinitis; SD, standard deviation.
aData represent no. (%) of patients unless otherwise specified.
bSignificant at P < .05.
cBMI calculated as weight in kilograms divided by height in meters squared.
dOther cardiovascular surgery included aortic surgery (8 of 60 patients), cardiac graft (3 of 60), and electronic cardiac device implantation (1 of 60);
eOther gastroesophageal procedures included hiatal hernia repair (4 of 36 patients); esophageal diverticulum surgery (3 of 36); and stomach ulcer suture, complicated ultrasonography-endoscopy, complicated transesophageal echocardiography, surgery for spontaneous rupture of the esophagus, and cervical corpectomy complicated by an esophageal fistula (each 1 of 36).
This PDF is available to Subscribers Only
View Article Abstract & Purchase OptionsFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.
