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Observational Study
. 2017 Sep;109(3):207-212.
doi: 10.5935/abc.20170119. Epub 2017 Aug 17.

Predictors of Mediastinitis Risk after Coronary Artery Bypass Surgery: Applicability of Score in 1.322 Cases

[Article in English, Portuguese]
Fabiana Dos Santos Oliveira  1 , Letícia Delfino Oliveira de Freitas  1 , Eneida Rejane Rabelo-Silva  1 , Laura Maggi da Costa  1 , Renato Abdala Karam Kalil  1 , Maria Antonieta Pereira de Moraes  1
Affiliations
Observational Study

Predictors of Mediastinitis Risk after Coronary Artery Bypass Surgery: Applicability of Score in 1.322 Cases

[Article in English, Portuguese]
Fabiana Dos Santos Oliveira et al. Arq Bras Cardiol. 2017 Sep.

Abstract

Background: Mediastinitis is a severe surgical complication of low incidence, but high lethality. Scores used in the preoperative period to stratify the risk of postoperative mediastinitis may contribute to improve the results.

Objective: To test the applicability of the MagedanzSCORE in predicting the risk factors for mediastinitis in patients undergoing coronary artery bypass grafting at a cardiology reference hospital.

Methods: Historical cohort study with adult patients who underwent coronary artery bypass grafting. The analyzed variables were contemplated in the MagedanzSCORE: reoperation, chronic obstructive pulmonary disease (COPD), obesity, class IV unstable angina, polytransfusion therapy, mediastinitis and death as outcome variables.

Results: Of the 1.322 patients examined, 56 (4.2%) developed mediastinitis. Of these, 26 (46.4%) were classified as high risk for mediastinitis and 15 (26.8%) at very high risk for mediastinitis. Three of the five variables of the Magendanz Score showed statistically significant differences: reoperation, COPD and obesity. Class IV unstable angina and postoperative polytransfusion were not associated with mediastinitis after coronary artery by-pass grafting. The area under the ROC curve was 0.80 (CI 95% 0.73 - 0.86), indicating the model's satisfactory ability to predict the occurrence of mediastinitis.

Conclusion: The tool was useful in the preoperative assessment demonstrating the risk for mediastinitis in this population of intensive care patients. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Presence of mediastinitis according to MagedanzSCORE. N = 56.
Figure 2
Figure 2
Area over the ROC curve in the measurement of the occurrence of mediastinitis. C: area under ROC curve; 95% CI: 95% confidence interval; 0.80 (95% CI 0.73-0.87).
See this image and copyright information in PMC

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