{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:42:40Z","timestamp":1760233360600,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T00:00:00Z","timestamp":1610064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MIUR Art.11-DM 593-08\/08\/20","award":["22\/12"],"award-info":[{"award-number":["22\/12"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background. Sternal wound complications are serious events that occur after cardiac surgery. Few studies have investigated the predictive value of chest X-ray radiological measurements for sternal complications. Methods. Several perioperative radiological measurements at chest X-ray and clinical characteristics were computed in 849 patients deemed at high risk for sternal dehiscence (SD) or More than Grade 1 Surgical Site Infection (MG1-SSI). Multivariable analysis identified independent predictors, whilst receiver operating characteristics (ROC) curve analyses highlighted cut-off values of radiological measurements for the prediction of both complications. Results. SD occurred in 8.8% of the patients, MG1-SSI in 6.8%. Chronic obstructive pulmonary disease (COPD) was the only independent predictor for SD (Odds Ratio, O.R. 12.1; p &lt; 0.001); proximal sternal height (PSH) was the only independent protective factor (O.R. 0.58; p &lt; 0.001), with a cut-off value of 11.7 mm (sensitivity 70.5%, specificity 71.0%; ROC area under the curve (AUC) = 0.768, p &lt; 0.001). Diabetes mellitus (O.R. 3.5; p &lt; 0.001) and COPD (O.R. 21.3; p &lt; 0.001) were independent predictors for MG1-SSI; indexed proximal sternal height (iPSH) was as a protective factor (O.R. 0.26; p &lt; 0.001) with a cut-off of 5.97 mm (sensitivity 70.2%, specificity 69.0%; ROC AUC = 0.739, p &lt; 0.001). No other radiological measurements were independently correlated with SD or MG1-SS (p = N.S.). Conclusion. PSH and iPSH at preoperative chest X-ray may act as indicators of high risk for sternal wound complications, allowing for early preventative measures.<\/jats:p>","DOI":"10.3390\/jcm10020207","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T19:55:56Z","timestamp":1610308556000},"page":"207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Value of Perioperative Chest X-ray for the Prediction of Sternal Wound Complications after Cardiac Surgery in High-Risk Patients: A \u201cWork in Progress\u201d Analysis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-7548","authenticated-orcid":false,"given":"Andrea","family":"Ardig\u00f2","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8674-3179","authenticated-orcid":false,"given":"Alessandra","family":"Francica","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Franco","family":"Veraldi","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, University Hospital in Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Tropea","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Tonelli","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Onorati","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-5761","authenticated-orcid":false,"given":"Giuseppe","family":"Faggian","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1053\/j.jvca.2019.09.019","article-title":"Deep sternal wound infection: Diagnosis, treatment and prevention","volume":"34","author":"Phoon","year":"2020","journal-title":"J. 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