Pak J Med Sci 2008 Vol. 24 No. 2 www.pjms.com.pk 251 Original Article INVESTIGATION OF DEEP STERNAL WOUND INFECTION AFTER CORONARY ARTERY BYPASS GRAFT AND ITS RISK FACTORS Mohammad Javad Hoseini 1 , Mohamad Hassan Naseri 2 , Moj t aba Tei moor i 3 ABSTRACT Objective: To investigate factors that predict sternal wound complications in patients after coronary artery bypass grafting (CABG) because prediction of deep sternal wound infection after surgery, might help us to do some interventions and reduce its consequences. Methodology: The record of all these patients was reviewed retrospectively. DSWI was defined according to the guidelines of the Centers for Disease Control and Prevention. From Sep 2003 to Sep 2006 a total of 1014 patients who underwent coronary bypass graft surgery in a cross-sectional study was included in this study. Result s: Logistic regression analysis was conducted and the risk factors that significantly predicted sternal wound complications after coronary artery bypass graft surgery included older age, Diabetes mellitus, increasing BMI, and in class three or four of the New York Heart Association functional class. Most infections had a late and the maj ority of these were caused by staphylococcus epidermidis while other were pseudomonas aeroginosa, streptococcus pneumonia, staphylococcus aureus and one of t hem was Meticilline resistance. The clinically most fulminate infections were caused by e-coli and presented early after surgery. Conclusion: Advanced age, diabetes and obesity, NYHA high score were the important risk factors identified. As such we suggest more attention should be paid to these patient. Modifying the risk factor and making decision according to risk factor such as appropriate administration of prophylactic antibiotic in patient with poor physical status, good control diabetes are recommended. KEY WORDS: Mediastinitis, Wound infection, CABG, Risk factors. Pak J Med Sci April - June 2008 (Part-I) Vol. 24 No. 2 251-256 1. Mohammad Javad Hoseini, MD, Department of infectious disease, Molecular Biology Research Centre, Baqyatallah Medical School University, Mollasadra Street, Tehran, Iran. 2. Mohamad Hassan Naseri, MD, Department of Cardiovascular Surgery, 3. Mojtaba Teimoori Medical Students, Scientific Research Centre, Eleventh floor, Medical Faculty, 1-3: Baqatallah University of Medical Sciences, Mollasadra Street, Tehran, Iran. Correspondence Dr. Mojtaba Teimoori E-mail: mojtaba_teimoori@yahoo.com * Received for Publication: November 24, 2007 * Accepted: January 17, 2008 INTRODUCTION Infection remains the most common cause of postoperative morbidity and mortality. 1 Sternal wound infection (SWI) is a serious infection after cardiac surgery. 2 Deep sternal wound infection (DSWI) is associated with sternal osteomyelitis with or without infected retrosternal space (bone and mediastinitis). 3 The reported incidence of DSWI ranges between 0.15% and 8%, 4 the reported in- hospital mortality can be as high as 20% to up 50%. 1-5-6 SWI following CABG is associated with increased long-term mortality 5 and extend the lengths of stay and increase the cost. 6 Studies have consistently associated obesity and re-operation with this complication, while