Cardiothoracic & vascular anesthesia
Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome
Authors' conclusion
Fungal mediastinitis is a very rare complication after cardiac surgery, associated with a high mortality rate.
Study context
- Population
- Patients with proven fungal mediastinitis after cardiac surgery, 2009–2019of 73,688 procedures
- Participants
- 40 patients
- Exposure
- Survivors vs non-survivors
- Outcome
- Incidence, characteristics and outcome of post-cardiac surgery fungal mediastinitis
Methodological detailsmulticentre, 10 Intensive Care Units (ICUs) in France and Belgium
- Multicentre
- 10 ICUs in France and Belgium
Main finding
As reported in the abstract
Fungal mediastinitis incidence and hospital mortality
- Patients developing fungal mediastinitis among 73,688 cardiac surgery procedures
- 40
- Hospital mortality
- 58%
- Interval from initial surgery to mediastinitis (days)
- 38 [17-61]
- Septic shock at diagnosis
- 12.5%
- Candida spp. (patients)
- 34
- Trichosporon spp. (patients)
- 5
- Aspergillus spp. (patients)
- 4
- Fungal strains identified
- 43
- LVAD before initial surgery
- 5
- VA-ECMO before initial surgery
- 5
- Prior heart transplantation
- 12
Observational data: associations, not effects.
Further findings
Age (yo), survivors vs non-survivors
P = 0.013
BMI
P = 0.028
| Outcome | Survivors | Non-survivors | P value |
|---|---|---|---|
| SAPS II at ICU admission | 37 (IQR 28–40) | 54 (IQR 34–61) | P = 0.012 |
Original publication
Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome. Crit Care. Published 6 January 2023. doi:10.
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