Sa et al reported a score for predicting the risk of a deep sternal infection following a coronary artery bypass graft (CABG) procedure. This can help to identify a patient who may benefit from more aggressive management. The authors are from Pronto-Socorro Cardiologica de Purnambuco in Brazil.
Patient selection: adult undergoing a CABG procedure
Parameters:
(1) obesity (body mass index >= 30 kg per sq meter)
(2) diabetes
(3) smoking
(4) pedicled ITA=internal thoracic artery (vs skeletonized; the pedicled procedure involves direct dissection of a surrounding margin of tissue around the artery using electrocautery)
(5) on-pump CABG
Parameter
Finding
Points
obesity
no
0
yes
3
diabetes
no
0
yes
3
smoking
no
0
yes
2
pedicled ITA
no
0
yes
5
on-pump CABG
no
0
yes
2
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the greater the risk of infection.
Score
Risk Group
Percent with SSI
0 to 6
low
0.6%
7 to 9
medium
3.9%
10 to 15
high
15.7%
Performance:
• The area under the ROC curve between 0.73 and 0.82.
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