Arq. Bras. Cardiol. 2017; 109(3): 207-212
Predictors of Mediastinitis Risk after Coronary Artery Bypass Surgery: Applicability of Score in 1.322 Cases
DOI: 10.5935/abc.20170119
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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