Produção Nacional
Elaboração de escore de risco para mediastinite pós-cirurgia de revascularização do miocárdio
2010; Brazilian Society of Cardiovascular Surgery; Volume: 25; Issue: 2 Linguagem: Inglês
10.1590/s0102-76382010000200005
ISSN1678-9741
AutoresEllen Hettwer Magedanz, Luiz Carlos Bodanese, João Carlos Vieira da Costa Guaragna, Luciano Cabral Albuquerque, Valério Martins, Sílvia Daniela Minossi, Jacqueline da Costa Escobar Piccoli, Marco Antônio Goldani,
Tópico(s)Venous Thromboembolism Diagnosis and Management
ResumoThe mediastinitis is a serious postoperative complication of cardiac surgery, with an incidence of 0.4 to 5% and mortality between 14 and 47%. Several models were proposed to assess risk of mediastinitis after cardiac surgery. However, most of these models do not evaluate the postoperative morbidity.This study aims to develop a score risk model to predict the risk of mediastinitis for patients undergoing coronary artery bypass grafting.The study sample included data from 2,809 adult patients undergoing coronary artery bypass grafting between January 1996 and December 2007 at Hospital São Lucas -PUCRS. Logistic regression was used to examine the relationship between risk factors and the development of mediastinitis. Data from 1,889 patients were used to develop the model and its performance was evaluated in the remaining data (n=920). The definitive model was created with the data analysis of 2,809 patients.The rate of mediastinitis was 3.3%, with mortality of 26.6%. In the multivariate analysis, five variables remained independent predictors of the outcome: chronic obstructive pulmonary disease, obesity, surgical reintervention, blood transfusion and stable angina class IV or unstable. The area under the ROC curve was 0.72 (95% CI, 0.67-0.78) and P = 0.61.The risk score was constructed for use in daily practice to calculate the rate of mediastinitis after coronary artery bypass grafting. The score includes routinely collected variables and is simple to use.
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