ArticleJournal of cardiothoracic surgery2021
Development of a new sternal dehiscence prediction scale for decision making in sternal closure techniques after cardiac surgery.
Article in Journal of cardiothoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 15 citations in OpenAlex.
- A Retrospective Application of Deep Sternal Wound Dehiscence and Malunion Risk Scores on Sternal Nonunion Patients.Plastic and reconstructive surgery. Global open · 2025Article
- Immunonutritional Markers and the Protective Role of Sternal Irrigation and Antibiotic-Impregnated Membranes in Sternal Wound Infection: A Retrospective Cohort Study.Life (Basel, Switzerland) · 2025Article
- Sternal reconstruction using titanium plates for complicated upper hemi-sternum dehiscence.Journal of surgical case reports · 2025Article
- Reliability of Ultrasonographic Assessment of Sternal Micromotions by Physiotherapists in Patients with Median Sternotomy.Journal of clinical medicine · 2025Article
- Combined Band and Plate Fixation as a New Individual Option for Patients at Risk of Sternal Complications after Cardiac Surgery: A Single-Center Experience.Biomedicines · 2023Article
- Tradition or Innovation in Sternal Dehiscence Repair: Robicsek Versus Titanium Plate.Sisli Etfal Hastanesi tip bulteni · 2023Article
- [Atrophic sternum nonunion-Case report based on the nonunion scoring system].Unfallchirurgie (Heidelberg, Germany) · 2022Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter sternotomy, the spectrum for sternal osteosynthesis comprises standard wiring and more complex techniques, like titanium plating. The aim of this study is to develop a predictive risk score that evaluates the risk of sternum instability individually. The surgeon may then choose an appropriate sternal osteosynthesis technique that is risk- adjusted as well as cost-effective.
methodsData from 7.173 patients operated via sternotomy for all cardiovascular indications from 2008 until 2017 were retrospectively analyzed. Sternal dehiscence occurred in 2.5% of patients (n = 176). A multivariable analysis model examined pre- and intraoperative factors. A multivariable logistic regression model and a backward elimination based on the Akaike Information Criterion (AIC) a logistic model were selected.
resultsThe model showed good sensitivity and specificity (area under the receiver-operating characteristic curve, AUC: 0.76) and several predictors of sternal instability could be evaluated. Multivariable logistic regression showed the highest Odds Ratios (OR) for reexploration (OR 6.6, confidence interval, CI [4.5-9.5], p < 0.001), obesity (body mass index, BMI > 35 kg/m
conclusionsA weighted scoring system based on individual risk factors was specifically created to predict sternal dehiscence. High-scoring patients should receive additive closure techniques.
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