No abstract

Background Aboriginal and Torres Strait Islander (Indigenous) Australians have an increased prevalence of coronary artery disease and present at a younger age for coronary artery bypass graft surgery (CABG) when compared to non‐Indigenous Australians. Studies have reported postoperative outcomes in Indigenous people to be less favourable. Therefore, the aim of this study is to evaluate long term mortality between Indigenous and non‐Indigenous people post‐CABG. Methods We analysed data on all patients who underwent isolated CABG, with and without cardiopulmonary bypass, at our institution between January 1998 to September 2008. There were 33 395 person‐years of survival for analysis with a median follow‐up of 13 years (Interquartile range (IQR): 8–16 years). We analysed all‐cause mortality with the Kaplan–Meier graph and log‐rank test. Univariate and multivariate analysis was performed using a Cox proportional hazards model. Results The mean age at presentation for Indigenous people was 52 years compared to 65 yr for non‐indigenous people. There were 1431 (52.1%) deaths by the study census date, with the overall mortality for Indigenous patients at 49.8% (n = 147) and 52.4% for non‐Aboriginal patients (n = 1284). The age and comorbidities adjusted hazard ratio (HR) for all‐cause late mortality (median years) was HR = 1.712 (95% CI: 1.288–2.277, p < 0.001). Conclusion Indigenous patients present for CABG at a younger age and have a higher prevalence of comorbidities. Our study demonstrates they have a higher risk of propensity adjusted all‐cause long term mortality. Primary and secondary prevention strategies, tailored to Indigenous people, may improve health outcomes in the long‐term post‐CABG.

Sternal wound infections after cardiac surgery are associated with high rates of morbidity and mortality. One of the known risk factors of sternal wound infection is Staphylococcus aureus colonisation. Intranasal mupirocin decolonisation therapy implemented pre-operatively appears to be an effective preventative measure in reducing sternal wound infections post-cardiac surgery. Therefore, the main aim of this review is to evaluate the current literature regarding the use of intranasal mupirocin before cardiac surgery and its impact on sternal wound infection rates.