Latitude of the study place and age of the patient are associated with incidence of mediastinitis and microbiology in open-heart surgery: a systematic review and meta-analysis.

摘要: OBJECTIVE We aimed to summarize the pooled frequency of mediastinitis following open-heart surgery caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), and Gram-negative bacteria. DESIGN This study was a systematic review meta-analysis prospective retrospective cohort studies. MATERIALS AND METHODS searched literature, total 97 studies were identified. Random-effect model used synthesize results. Heterogeneity between examined subgroup meta-regression analyses, considering patient-level variables. Small-study effect evaluated. RESULTS Substantial heterogeneity present. The estimated incidence evaluated from 1.58% (95% confidence intervals [CI] 1.42, 1.75) that MRSA bacteria 63 0.90% CI 0.81, 1.21), 0.24% 0.18, 0.32), 0.08% 0.05, 0.12), respectively. A pinpointed negative association latitude place positive age patient at operation. Multivariate showed design patients together or in combination accounted for 17% end point mediastinitis, 16.3% 14.7% 23.3% CONCLUSION Evidence this suggests importance advanced as risk factors mediastinitis. Latitude is marker thermally regulated bacterial virulence other local surgical practice. There concern increasing elderly undergoing sternotomy.