Equations of Gatti et al for Predicting Deep Sternal Wound Infection (DSWI) After Bilateral Internal Thoracic Artery Grafting: Combined Model

Description

Gatti et al evaluated patients for the risk of deep sternal wound infection (DSWI) following bilateral internal thoracic artery (BITA) grafting. They reported 2 predictive models, with one based on perioperative findings. The authors are from Ospedali Riuniti and University of Trieste in Italy.

Patient selection: CABG using bilateral internal thoracic artery grafts

Outcome: deep sternal wound infection (DSWI) and mediastinitis

Parameters:

(1) sex

(2) body mass index (BMI) in kilograms per square meter

(3) diabetes status

(4) glycemic control

(5) chronic lung disease

(6) surgical acuity

(7) use of chlorhexidine-alcohol

(8) porcelain aorta by intraoperative EAS (epiaortic ultrasonography scan)

(9) low cardiac output postoperatively

(10) number of red blood cell transfusions

(11) mediastinal re-exploration in the postoperative period

Parameter	Finding	Points
sex	male	0
	female	66
BMI	<= 30	0
	> 30	24
diabetes	none	0
	on oral hypoglycemic agent	31
	on insulin	54
glycemic control	good or fair	0
	poor	46
chronic lung disease	absent	0
	present	62
surgical acuity	elective	0
	urgent	28
use of chlorhexidine-alcohol	no	0
	yes	51
porcelain aorta	no	0
	yes	36
low cardiac output	no	0
	yes	100
number of RBC transfusions	<= 2	0
	> 2	35
mediastinal re-exploration	no	0
	yes	39

total score =

= SUM(points for all 11 parameters)

Interpretation:

• minimum score: 0

• maximum score: 541

• The higher the score the greater the risk for DSWI.

Total Score	Risk DSWI
< 127	< 10%
127-154	10%
155-175	15%
176-192	20%
193-207	25%
208-221	30%
222-233	35%
234-246	40%
247-258	45%
259-270	50%
271-282	55%
283-295	60%
296-308	65%
>= 309	>= 70%

Performance:

• The area under the ROC curve is 0.73.

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Equations of Gatti et al for Predicting Deep Sternal Wound Infection (DSWI) After Bilateral Internal Thoracic Artery Grafting: Combined Model

Description

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