There were no statistically significant differences in mortality , infections overall and adverse events .
Perioperative antibiotic prophylaxis of ≥24 hours may be more efficacious in preventing sternal SSIs in patients undergoing cardiac surgery compared to shorter regimens .
OBJECTIVE We aim ed to compare the efficacy of short-term ( < 24 hours ) versus longer-term antibiotic prophylaxis ( ≥24 hours ) in open heart surgery .
BACKGROUND The optimal duration of antibiotic prophylaxis for adults undergoing cardiac surgery is unknown and guideline recommendations are inconsistent .
The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1--coronary artery bypass grafting surgery.
BACKGROUND The first version of The Society of Thoracic Surgeons National Adult Cardiac Surgery Data base ( STS NCD ) was developed nearly 2 decades ago . Since its inception , the number of participants has grown dramatically , patient acuity has increased , and overall outcomes have consistently improved . To adjust for these and other changes , all STS risk models have undergone periodic revisions . This report provides a detailed description of the 2008 STS risk model for coronary artery bypass grafting surgery ( CABG ) . METHODS The study population consisted of 774,881 isolated CABG procedures performed on adult patients aged 20 to 100 years between January 1 , 2002 , and December 31 , 2006 , at 819 STS NCD participating centers . This cohort was r and omly divided into a 60 % training ( development ) sample and a 40 % test ( validation ) sample . The development sample was used to identify predictor variables and estimate model coefficients . The validation sample was used to assess model calibration and discrimination . Model outcomes included operative mortality , renal failure , stroke , reoperation for any cause , prolonged ventilation , deep sternal wound infection , composite major morbidity or mortality , prolonged length of stay ( > 14 days ) , and short length of stay ( < 6 days and alive ) . C and i date predictor variables were selected based on their availability in versions 2.35 , 2.41 , and 2.52.1 of the STS NCD and their presence in ( or ability to be mapped to ) version 2.61 . Potential predictor variables were screened for overall prevalence in the study population , missing data frequency , coding concerns , bivariate relationships with outcomes , and their presence in previous STS or other CABG risk models . Supervised backwards selection was then performed with input from an expert panel of cardiac surgeons and biostatisticians . After successfully validating the fit of the models , the development and validation sample s were subsequently combined , and the final regression coefficients were estimated using the overall combined ( development plus validation ) sample . RESULTS The c-index for the mortality model was 0.812 , and the c-indices for other endpoints ranged from 0.653 for reoperation to 0.793 for renal failure in the validation sample . Plots of observed versus predicted event rates revealed acceptable calibration in the overall population and in numerous subgroups . When patients were grouped into categories of predicted risk , the absolute difference between the observed and expected event rates was less than 1.5 % for each endpoint . The final model intercept and coefficients are provided . CONCLUSIONS New STS risk models have been developed for CABG mortality and eight other endpoints . Detailed descriptions of model development and testing are provided , together with the final algorithm . Overall model performance is excellent
There were no statistically significant differences in mortality , infections overall and adverse events .
Perioperative antibiotic prophylaxis of ≥24 hours may be more efficacious in preventing sternal SSIs in patients undergoing cardiac surgery compared to shorter regimens .
OBJECTIVE We aim ed to compare the efficacy of short-term ( < 24 hours ) versus longer-term antibiotic prophylaxis ( ≥24 hours ) in open heart surgery .
BACKGROUND The optimal duration of antibiotic prophylaxis for adults undergoing cardiac surgery is unknown and guideline recommendations are inconsistent .