title: Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery.
abstract: OBJECTIVE
  The aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - MagedanzSCORE - in patients undergoing coronary artery bypass graft (CABG) surgery in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE.
  
  
  METHODS
  Retrospective study involving 500 patients operated between May/2007 and April/2010. The registers contained all the information used to calculate the MagedanzSCORE. The outcome of interest was mediastinitis. We calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. The accuracy of the model was evaluated by ROC (receiver operating characteristic) curve.
  
  
  RESULTS
  The incidence of mediastinitis was 5.6%, with a lethality rate of 32.1%. In univariate analysis, the five variables of the MagedanzSCORE were predictors of postoperative mediastinitis: chronic obstructive pulmonary disease (OR 6.42; 95.0% CI 2.76-14.96; P<0.001), obesity (OR 3.06; 95.0% CI 1.32-7.09; P=0.009), surgical reintervention (OR 82.40; 95.0% CI 30.40-223.30; P<0.001), multiple transfusion (OR 3.33; 95.0% CI 1.52-7.29; P=0.003) and stable angina class IV or unstable (OR 2.59; 95.0% CI 1.19-7.64; P=0.016) according to Canadian Cardiovascular Society. The score had a sensitivity of 96.4%, specificity of 90.0%, positive predictive value of 36.5%, negative predictive value of 99.8% and 90.4% concordance. The accuracy measured by the area under the ROC curve was 96.2% (95.0% CI 94.5%-97.9%).
  
  
  CONCLUSIONS
  The MagedanzSCORE proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative mediastinitis in patients undergoing CABG surgery at our institution.
authors.affiliation: Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE; University of Pernambuco – UPE, Recife, PE, Brazil. michel_pompeu@yahoo.com.br
authors.forename: Michel Pompeu Barros de Oliveira
authors.initials: MP
authors.lastname: Sá
authors.forename: Evelyn Soares
authors.initials: ES
authors.lastname: Figueira
authors.forename: Cecília Andrade
authors.initials: CA
authors.lastname: Santos
authors.forename: Omar Jacobina
authors.initials: OJ
authors.lastname: Figueiredo
authors.forename: Renato Oliveira Albuquerque
authors.initials: RO
authors.lastname: Lima
authors.forename: Fábio Gonçalves de
authors.initials: FG
authors.lastname: Rueda
authors.forename: Rodrigo Renda de
authors.initials: RR
authors.lastname: Escobar
authors.forename: Alexandre Magno Macário Nunes
authors.initials: AM
authors.lastname: Soares
authors.forename: Ricardo de Carvalho
authors.initials: Rde C
authors.lastname: Lima
mesh_terms: D000787:Angina Pectoris / Q000150:complications; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods / Q000592:standards