External validity of the Society of Thoracic Surgeons risk stratification tool for deep sternal wound infection after cardiac surgery in a UK population

Abstract

The STS risk calculator lacks adequate discriminatory power for estimating the isolated risk of developing deep sternal wound infection in a UK population. The discrimination is similar to the tool's validation c-statistic and may have a place in an integrated calculator.

Arterial grafting and the risk of sternal infection: How we can learn from our experience

“…Even large data repository reports like that from the STS may have limited applicability to other patient populations. 25 These large registry findings are certainly corroborated by the hospital-level data reported by Shih and colleagues 17 from the Michigan experience, which essentially teach us that hospital-level, rather than patient-level factors account for more of the variance in postsurgical infection. The true message of Kieser and colleagues 18 -aside from the definitively actionable information related to minimizing the risk of DSWI while maintaining a commitment to arterial revascularization-is that it is ultimately the dedication to clinical improvement through rigorous self-examination and evidence-based programmatic adaptation that will drive surgical quality.…”

Incidence of sternal wound infection after tracheostomy in patients undergoing cardiac surgery: A systematic review and meta-analysis

“…The incidence of SWI in tracheostomy cases after cardiac surgery is larger than the general cardiac surgical population, which has been reported to range from 0.7% to 3.2%. [23][24][25] The increased incidence of SWI may be partially explained by several other risk factors present in postoperative tracheostomy cases. For example, in this meta-analysis of more than 10,000 patients, there was a high incidence of diabetic patients, elderly patients, patients with chronic obstructive lung disease, and patients undergoing reoperative surgery.…”

“…Meta-regression demonstrated no significant relationship between incidence of sternal wound infection and number of days between tracheostomy and initial cardiac surgery (R 2 ¼ 6.13%, P ¼ .72). Reported secondary outcomes included 30-day and 1-year mortality, which were high at 23% (95% CI, [19][20][21][22][23][24][25][26][27][28] and 63% (95% CI, 43-80), respectively.…”

“…Synthesis of results 21Present results of each meta-analysis done, including CIs and measures of consistency.Risk of bias across studies 22Present results of any assessment of risk of bias across studies (seeItem 15). 12 Additional analysis23 Give results of additional analyses, if done (eg, sensitivity or subgroup analyses, meta-regression [seeItem 16]).…”

Methodology of the Norwegian Surveillance System for Healthcare-Associated Infections: The value of a mandatory system, automated data collection, and active postdischarge surveillance

“…In the case of the cesarean sections, it will probably have few consequences, as there is no reason to believe that there is a systematic difference in infection risks between months. In the case of the hip arthroplasties and bypass surgery the consequences may be greater because the procedures which were lost had higher risk of infection, 110,111 and therefore the reported incidence rates would consequently be lower for these hospitals.…”