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 preoperative 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) chronic dialysis
(7) congestive heart failure
(8) surgical acuity
Parameter |
Finding |
Points |
sex |
male |
0 |
|
female |
99 |
BMI |
<= 30 |
0 |
|
> 30 |
33 |
diabetes |
none |
0 |
|
on oral hypoglycemic agent |
49 |
|
on insulin |
89 |
glycemic control |
good or fair |
0 |
|
poor |
58 |
chronic lung disease |
absent |
0 |
|
present |
100 |
chronic dialysis |
absent |
0 |
|
present |
92 |
congestive heart failure |
absent |
0 |
|
present |
58 |
surgical acuity |
elective |
0 |
|
urgent |
48 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 577
• The higher the score the greater the risk for DSWI.
Total Score |
Risk DSWI |
< 180 |
< 10% |
180-222 |
10% |
223-254 |
15% |
255-280 |
20% |
281-303 |
25% |
304-324 |
30% |
325-343 |
35% |
344-362 |
40% |
363-380 |
45% |
381-399 |
50% |
400-417 |
55% |
418-437 |
60% |
438-458 |
65% |
>= 459 |
>= 70% |
Performance:
• The area under the ROC curve is 0.72.
Specialty: Infectious Diseases, Surgery, general