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Development and validation of a stratification tool for predicting risk of deep sternal wound infection after coronary artery bypass grafting at a brazilian hospital
Sá, Michel Pompeu Barros Oliveira; Ferraz, Paulo Ernando; Soares, Artur Freire; Miranda, Rodrigo Gusmão Albuquerque; Araújo, Mayara Lopes; Silva, Frederico Vasconcelos; Lima, Ricardo de Carvalho.
Afiliação
  • Sá, Michel Pompeu Barros Oliveira; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Ferraz, Paulo Ernando; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Soares, Artur Freire; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Miranda, Rodrigo Gusmão Albuquerque; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Araújo, Mayara Lopes; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Silva, Frederico Vasconcelos; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
  • Lima, Ricardo de Carvalho; Pronto-Socorro Cardiológico de Pernambuco. Division of Cardiovascular Surgery. Recife. BR
Rev. bras. cir. cardiovasc ; 32(1): 1-7, Jan.-Feb. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-843468
Biblioteca responsável: BR1.1
ABSTRACT
Abstract

Objective:

Deep sternal wound infection following coronary artery bypass grafting is a serious complication associated with significant morbidity and mortality. Despite the substantial impact of deep sternal wound infection, there is a lack of specific risk stratification tools to predict this complication after coronary artery bypass grafting. This study was undertaken to develop a specific prognostic scoring system for the development of deep sternal wound infection that could risk-stratify patients undergoing coronary artery bypass grafting and be applied right after the surgical procedure.

Methods:

Between March 2007 and August 2016, continuous, prospective surveillance data on deep sternal wound infection and a set of 27 variables of 1500 patients were collected. Using binary logistic regression analysis, we identified independent predictors of deep sternal wound infection. Initially we developed a predictive model in a subset of 500 patients. Dataset was expanded to other 1000 consecutive cases and a final model and risk score were derived. Calibration of the scores was performed using the Hosmer-Lemeshow test.

Results:

The model had area under Receiver Operating Characteristic (ROC) curve of 0.729 (0.821 for preliminary dataset). Baseline risk score incorporated independent predictors of deep sternal wound infection obesity (P=0.046; OR 2.58; 95% CI 1.11-6.68), diabetes (P=0.046; OR 2.61; 95% CI 1.12-6.63), smoking (P=0.008; OR 2.10; 95% CI 1.12-4.67), pedicled internal thoracic artery (P=0.012; OR 5.11; 95% CI 1.42-18.40), and on-pump coronary artery bypass grafting (P=0.042; OR 2.20; 95% CI 1.13-5.81). A risk stratification system was, then, developed.

Conclusion:

This tool effectively predicts deep sternal wound infection risk at our center and may help with risk stratification in relation to public reporting and targeted prevention strategies in patients undergoing coronary artery bypass grafting.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Esterno / Infecção da Ferida Cirúrgica / Ponte de Artéria Coronária / Artéria Torácica Interna Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Rev. bras. cir. cardiovasc Assunto da revista: Cardiologia / CIRURGIA GERAL Ano de publicação: 2017 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Pronto-Socorro Cardiológico de Pernambuco/BR

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Esterno / Infecção da Ferida Cirúrgica / Ponte de Artéria Coronária / Artéria Torácica Interna Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Rev. bras. cir. cardiovasc Assunto da revista: Cardiologia / CIRURGIA GERAL Ano de publicação: 2017 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Pronto-Socorro Cardiológico de Pernambuco/BR
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