Early prediction of 30-day mortality in patients with surgical wound infections following cardiothoracic surgery: Development and validation of the SWICS-30 score utilizing conventional logistic regression and artificial neural network

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases Pub Date : 2025-02-21 DOI:10.1016/j.bjid.2025.104510

Julio Alejandro Cedeno , Tania Mara Varejão Strabelli , Bruno Adler Maccagnan Pinheiro Besen , Rafael de Freitas Souza , Denise Blini Sierra , Leticia Rodrigues Goulart de Souza , Samuel Terra Gallafrio , Cely Saad Abboud , Diego Feriani , Rinaldo Focaccia Siciliano

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Abstract

Introduction

We aimed to create and validate the 30-day prognostic score for mortality in patients with surgical wound infection (SWICS-30) after cardiothoracic surgery.

Methods

This retrospective study enrolled patients with surgical wound infection following cardiothoracic surgery admitted to a Cardiologic Reference Center Hospital between January 2006 and January 2023. Clinical data and commonly used blood tests were analyzed at the time of diagnosis. An independent scoring system was developed through logistic regression analysis and validated using Artificial intelligence.

Results

From 1713 patients evaluated (mean age of 60 years (18–89), 55 % female), 143 (8.4 %) experienced 30-day mortality. The SWICS-30 logistic regression score comprised the following variables: age over 65 years, undergoing valve heart surgery, combined coronary and valve heart surgery, heart transplantation, time from surgery to infection diagnosis exceeding 21 days, leukocyte count over 13,000/mm3, lymphocyte count below 1000/mm3, platelet count below 150,000/mm3, and creatinine level exceeding 1.5 mg/dL. These patients were stratified into low (2.7 %), moderate (14.2 %), and high (47.1 %) in-hospital mortality risk categories. Artificial intelligence confirmed accuracy at 90 %.

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来源期刊

Brazilian Journal of Infectious Diseases 医学-传染病学

CiteScore

5.50

自引率

0.00%

发文量

925

审稿时长

41 days

期刊介绍： The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents. The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor, since its inception it has garnered a growing share of the publishing market.