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A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery

Various scoring systems attempt to predict the risk of surgical site infection (SSI) after cardiac surgery, but their discrimination is limited. Our aim was to analyze all SSI risk factors in both coronary artery bypass graft (CABG) and valve replacement patients in order to create a new SSI risk sc...

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Autores principales: Bustamante-Munguira, Juan, Herrera-Gómez, Francisco, Ruiz-Álvarez, Miguel, Hernández-Aceituno, Ana, Figuerola-Tejerina, Angels
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517895/
https://www.ncbi.nlm.nih.gov/pubmed/30970636
http://dx.doi.org/10.3390/jcm8040480
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author Bustamante-Munguira, Juan
Herrera-Gómez, Francisco
Ruiz-Álvarez, Miguel
Hernández-Aceituno, Ana
Figuerola-Tejerina, Angels
author_facet Bustamante-Munguira, Juan
Herrera-Gómez, Francisco
Ruiz-Álvarez, Miguel
Hernández-Aceituno, Ana
Figuerola-Tejerina, Angels
author_sort Bustamante-Munguira, Juan
collection PubMed
description Various scoring systems attempt to predict the risk of surgical site infection (SSI) after cardiac surgery, but their discrimination is limited. Our aim was to analyze all SSI risk factors in both coronary artery bypass graft (CABG) and valve replacement patients in order to create a new SSI risk score for such individuals. A priori prospective collected data on patients that underwent cardiac surgery (n = 2020) were analyzed following recommendations from the Reporting of studies Conducted using Observational Routinely collected health Data (RECORD) group. Study participants were divided into two periods: the training sample for defining the new tool (2010–2014, n = 1298), and the test sample for its validation (2015–2017, n = 722). In logistic regression, two preoperative variables were significantly associated with SSI (odds ratio (OR) and 95% confidence interval (CI)): diabetes, 3.3/2–5.7; and obesity, 4.5/2.2–9.3. The new score was constructed using a summation system for punctuation using integer numbers, that is, by assigning one point to the presence of either diabetes or obesity. The tool performed better in terms of assessing SSI risk in the test sample (area under the Receiver-Operating Characteristic curve (aROC) and 95% CI, 0.67/055–0.76) compared to the National Nosocomial Infections Surveillance (NNIS) risk index (0.61/0.50–0.71) and the Australian Clinical Risk Index (ACRI) (0.61/0.50–0.72). A new two-variable score to preoperative SSI risk stratification of cardiac surgery patients, named Infection Risk Index in Cardiac surgery (IRIC), which outperforms other classical scores, is now available to surgeons. Personalization of treatment for cardiac surgery patients is needed.
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spelling pubmed-65178952019-05-31 A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery Bustamante-Munguira, Juan Herrera-Gómez, Francisco Ruiz-Álvarez, Miguel Hernández-Aceituno, Ana Figuerola-Tejerina, Angels J Clin Med Article Various scoring systems attempt to predict the risk of surgical site infection (SSI) after cardiac surgery, but their discrimination is limited. Our aim was to analyze all SSI risk factors in both coronary artery bypass graft (CABG) and valve replacement patients in order to create a new SSI risk score for such individuals. A priori prospective collected data on patients that underwent cardiac surgery (n = 2020) were analyzed following recommendations from the Reporting of studies Conducted using Observational Routinely collected health Data (RECORD) group. Study participants were divided into two periods: the training sample for defining the new tool (2010–2014, n = 1298), and the test sample for its validation (2015–2017, n = 722). In logistic regression, two preoperative variables were significantly associated with SSI (odds ratio (OR) and 95% confidence interval (CI)): diabetes, 3.3/2–5.7; and obesity, 4.5/2.2–9.3. The new score was constructed using a summation system for punctuation using integer numbers, that is, by assigning one point to the presence of either diabetes or obesity. The tool performed better in terms of assessing SSI risk in the test sample (area under the Receiver-Operating Characteristic curve (aROC) and 95% CI, 0.67/055–0.76) compared to the National Nosocomial Infections Surveillance (NNIS) risk index (0.61/0.50–0.71) and the Australian Clinical Risk Index (ACRI) (0.61/0.50–0.72). A new two-variable score to preoperative SSI risk stratification of cardiac surgery patients, named Infection Risk Index in Cardiac surgery (IRIC), which outperforms other classical scores, is now available to surgeons. Personalization of treatment for cardiac surgery patients is needed. MDPI 2019-04-09 /pmc/articles/PMC6517895/ /pubmed/30970636 http://dx.doi.org/10.3390/jcm8040480 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bustamante-Munguira, Juan
Herrera-Gómez, Francisco
Ruiz-Álvarez, Miguel
Hernández-Aceituno, Ana
Figuerola-Tejerina, Angels
A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery
title A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery
title_full A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery
title_fullStr A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery
title_full_unstemmed A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery
title_short A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery
title_sort new surgical site infection risk score: infection risk index in cardiac surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517895/
https://www.ncbi.nlm.nih.gov/pubmed/30970636
http://dx.doi.org/10.3390/jcm8040480
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