Oliveira Fabiana Dos Santos, Freitas Letícia Delfino Oliveira de, Rabelo-Silva Eneida Rejane, Costa Laura Maggi da, Kalil Renato Abdala Karam, Moraes Maria Antonieta Pereira de
Instituto de Cardiologia / Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brazil.
Arq Bras Cardiol. 2017 Sep;109(3):207-212. doi: 10.5935/abc.20170119. Epub 2017 Aug 17.
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.
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.
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.
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.
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).
纵隔炎是一种严重的手术并发症，发病率低但致死率高。术前用于分层术后纵隔炎风险的评分可能有助于改善治疗结果。
在一家心脏病专科医院，测试马根丹兹评分（MagedanzSCORE）在预测冠状动脉搭桥术患者纵隔炎危险因素方面的适用性。
对接受冠状动脉搭桥术的成年患者进行历史性队列研究。马根丹兹评分中考虑的分析变量包括：再次手术、慢性阻塞性肺疾病（COPD）、肥胖、IV级不稳定型心绞痛、多次输血治疗、纵隔炎和死亡作为结局变量。
在1322例接受检查的患者中，56例（4.2%）发生了纵隔炎。其中，26例（46.4%）被归类为纵隔炎高风险，15例（26.8%）为纵隔炎极高风险。马根丹兹评分的五个变量中有三个显示出统计学上的显著差异：再次手术、COPD和肥胖。IV级不稳定型心绞痛和术后多次输血与冠状动脉搭桥术后纵隔炎无关。ROC曲线下面积为0.80（95%CI 0.73 - 0.86），表明该模型预测纵隔炎发生的能力令人满意。
该工具在术前评估中有用，可证明该重症监护患者群体中纵隔炎的风险。（《巴西心脏病学杂志》。2017年；[在线]。预印本，第0 - 0页）
