Fernandez-Ugidos et al reported a score for predicting in-hospital infection following heart transplant surgery. This can help to identify a patient who may require more aggressive management. The authors are from Complexo Hospitalario Universitario Ourense, Complexo Hospitalario Universitario A Coruna, Instituto de Salud Carlos III and Hospital Quironsalud Miguel Dominguez Pontevedra in Spain.
Patient selection: heart transplantation
Parameters:
(1) pretransplant mechanical ventilation
(2) history of diabetes mellitus
(3) previous sternotomy
(4) primary graft failure
(5) major surgical bleeding
(6) antiproliferative agent
(7) antifungal prophylaxis
Parameter
Finding
Points
pretransplant ventilation
no
0
yes
2
diabetes mellitus
no
0
yes
1
previous sternotomy
no
0
yes
1
primary graft failure
no
0
yes
1
major surgical bleeding
no
0
yes
1
antiproliferative agent
none
0
azathioprine
0
mycophenolate mofetil
1
antifungal prophylaxis
none
0
amphotericin B
0
itraconazole
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the greater the risk of in-hospital postoperative infection.
Total Score
Risk Group
Percent Infection
0 or 1
low
11-19%
2 or 3
medium
30-45%
4 to 8
high
63-100%
Performance:
• The area under the ROC curve is 0.74.
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