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Preoperative risk s...
Preoperative risk stratification of deep sternal wound infection after coronary surgery
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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2020-01-20
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Cambridge University Press (CUP),2020
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LIBRIS-ID:oai:prod.swepub.kib.ki.se:143409557
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http://kipublications.ki.se/Default.aspx?queryparsed=id:143409557URI
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https://doi.org/10.1017/ice.2019.375DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Objective:To develop a risk score for deep sternal wound infection (DSWI) after isolated coronary artery bypass grafting (CABG).Design:Multicenter, prospective study.Setting:Tertiary-care referral hospitals.Participants:The study included 7,352 patients from the European multicenter coronary artery bypass grafting (E-CABG) registry.Intervention:Isolated CABG.Methods:An additive risk score (the E-CABG DSWI score) was estimated from the derivation data set (66.7% of patients), and its performance was assessed in the validation data set (33.3% of patients).Results:DSWI occurred in 181 (2.5%) patients and increased 1-year mortality (adjusted hazard ratio, 4.275; 95% confidence interval [CI], 2.804–6.517). Female gender (odds ratio [OR], 1.804; 95% CI, 1.161–2.802), body mass index ≥30 kg/m2(OR, 1.729; 95% CI, 1.166–2.562), glomerular filtration rate <45 mL/min/1.73 m2(OR, 2.410; 95% CI, 1.413–4.111), diabetes (OR, 1.741; 95% CI, 1.178–2.573), pulmonary disease (OR, 1.935; 95% CI, 1.178–3.180), atrial fibrillation (OR, 1.854; 95% CI, 1.096–3.138), critical preoperative state (OR, 2.196; 95% CI, 1.209–3.891), and bilateral internal mammary artery grafting (OR, 2.088; 95% CI, 1.422–3.066) were predictors of DSWI (derivation data set). An additive risk score was calculated by assigning 1 point to each of these independent risk factors for DSWI. In the validation data set, the rate of DSWI increased along with the E-CABG DSWI scores (score of 0, 1.0%; score of 1, 1.8%; score of 2, 2.2%; score of 3, 6.9%; score ≥4: 12.1%;P< .0001). Net reclassification improvement, integrated discrimination improvement, and decision curve analysis showed that the E-CABG DSWI score performed better than other risk scores.Conclusions:DSWI is associated with poor outcome after CABG, and its risk can be stratified using the E-CABG DSWI score.Trial registration:clinicaltrials.gov identifier: NCT02319083
Added entries (persons, corporate bodies, meetings, titles ...)
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Gatti, G
(author)
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Rosato, S
(author)
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Mariscalco, G
(author)
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Pappalardo, A
(author)
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Onorati, F
(author)
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Faggian, G
(author)
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Salsano, A
(author)
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Santini, F
(author)
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Ruggieri, VG
(author)
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Perrotti, A
(author)
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Santarpino, G
(author)
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Fischlein, T
(author)
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Saccocci, M
(author)
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Musumeci, F
(author)
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Rubino, AS
(author)
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De Feo, M
(author)
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Bancone, C
(author)
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Nicolini, F
(author)
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Kinnunen, EM
(author)
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Demal, T
(author)
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D'Errigo, P
(author)
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Juvonen, T
(author)
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Dalen, MKarolinska Institutet
(author)
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Maselli, D
(author)
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Karolinska Institutet
(creator_code:org_t)
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In:Infection control and hospital epidemiology: Cambridge University Press (CUP)41:4, s. 444-4511559-68340899-823X
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Biancari, F
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Gatti, G
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Rosato, S
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Mariscalco, G
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Pappalardo, A
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Onorati, F
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Faggian, G
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Salsano, A
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Santini, F
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Ruggieri, VG
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Perrotti, A
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Santarpino, G
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Fischlein, T
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Saccocci, M
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Musumeci, F
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Rubino, AS
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De Feo, M
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Bancone, C
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Nicolini, F
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Kinnunen, EM
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Demal, T
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D'Errigo, P
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Juvonen, T
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Dalen, M
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Maselli, D
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Karolinska Institutet