Conservative treatment of vascular prosthetic graft infection is associated with high mortality

Am J Surg. 2010 Jul;200(1):47-52. doi: 10.1016/j.amjsurg.2009.05.018. Epub 2010 Jan 15.

Abstract

Background: The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections.

Methods: Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with central prosthetic graft infections. Univariate and multivariate analyses were performed to define factors predictive of mortality.

Results: Thirty-three men and 11 women (mean age, 71 years) were included. There was considerable comorbidity. Coagulase-negative Staphylococcus and S aureus were isolated in almost 50% of the patients. The mean follow-up duration was 5 years, during which 20 patients (46%) died. The main causes of death were related to vascular disease. Conservative treatment with antibiotics was the only variable with significant predictive value on multivariate analysis (hazard ratio, 3.62; 95% confidence interval, 1.17-11.24; P = .02).

Conclusions: Conservative treatment of prosthetic graft infections was associated with high mortality; therefore, it should be limited to a specific group. Patients who are not capable of undergoing open repair may benefit from conservative management. Otherwise, aggressive open treatment seems indicated.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm / complications
  • Aneurysm / mortality
  • Aneurysm / therapy
  • Anti-Bacterial Agents / therapeutic use*
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / mortality
  • Arterial Occlusive Diseases / therapy
  • Blood Vessel Prosthesis / adverse effects*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polyethylene Terephthalates
  • Polytetrafluoroethylene
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / mortality*
  • Prosthesis-Related Infections / therapy*
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Polyethylene Terephthalates
  • Polytetrafluoroethylene