Fu et al identified risk factors for infection of a sternal wound following open cardiac surgery. These can help to identify a patient who may benefit from more aggressive management to avoid the complication. The authors are from New York-Presbyterian Hospital and Columbia University Medical Center in New York City.
Patient selection: median sternotomy for open heart surgery
Parameters from multivariate analysis:
(1) internal mammary artery (IMA) grafting with or without previous grafting
(2) respiratory failure
Parameter
Finding
Points
IMA grafting
absent
0
present
1
respiratory failure
absent
0
present
1
number of risk factors =
= SUM(points for all 2 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 2
• The risk increases with the number of risk factors present.
Additional factors from univariate analysis:
(1) obesity with BMI > 30 kg per square meter
(2) left ventricular ejection fraction < 40%
(3) urgent or emergency surgery
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