title: An update review on risk factors and scales for prediction of deep sternal wound infections.
abstract: Surgical site infections are the most common nosocomial infections in surgical patients. The preventable and the unmodifiable risk factors for deep sternal wound infections (DSWI) have been amply assessed in the literature. The aim of this review was to describe the results of the numerous published studies to describe all the DSWI risk factors and the scales devised to predict SWI, with a view to providing an update on this issue. A comprehensive search of the Medline and Embase databases was performed (considering studies from January 1995 to April 2011); and a manual search was also conducted using references cited in original publications and relevant review articles. There are several risk factors associated with DSWI, which could be classified in four categories as demographic (e.g. sex and age), behavioural (e.g. smoking and obesity), baseline clinical conditions (e.g. diabetes, hypertension and COPD) and surgical operative risk factors (e.g. duration of operation and emergency operation). Six scales for predicting the risk of DSWI are described in the literature: they vary not only in accuracy but also in ease of application and they are applied at different times (some only preoperatively and others also postoperatively). This study provides a broad update on our knowledge of the risk factors for DSWI and the scales for prediction with a view to improving the management of infections at cardiosurgery units.
authors.affiliation: Department of Environmental Medicine and Public Health, University of Padua, Padua 35127, Italy. alessandra.buja@unipd.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Buja
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zampieron
authors.forename: Sara
authors.initials: S
authors.lastname: Cavalet
authors.forename: Daniele
authors.initials: D
authors.lastname: Chiffi
authors.forename: Paolo
authors.initials: P
authors.lastname: Sandonà
authors.forename: Angela
authors.initials: A
authors.lastname: Vinelli
authors.forename: Tatjana
authors.initials: T
authors.lastname: Baldovin
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Baldo
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D056346:Sternotomy / Q000009:adverse effects* / Q000379:methods; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy