Predictive risk score for infection after inguinal hernia repair - 18/08/11
, Emilie Lermite, M.D., Eric Blezel, M.D., Simon Msika, M.D., Ph.D., Jean-Marie Hay, M.D., Yves Flamant, M.D., Varma Deepak, M.D., Jean-Pierre Arnaud, M.D.French Associations for Surgical Research
Corresponding author. Tel.: +33 2 41 35 36 18; fax: +33 2 41 35 47 42.Abstract |
Background |
Identification of subgroups of patients at high and low risk for global infectious complications (GIC) after inguinal hernia repair without mesh.
Methods |
A database of 1254 patients who underwent inguinal hernia repair without mesh, issued from 3 prospective multicenter randomized trials, has been established (group A). After multivariate analysis, a score for GIC was calculated and tested using data from a similar prospective randomized multicenter study (group B).
Results |
A risk score for GIC was constructed: −4.7 + (0.95 × age ≥75 years) + (1.1 obesity) + (2.1 × urinary catheter). In case of score less than −4.2 (low-risk group), the GIC rate was 2.7%; therefore, in case of score more than −4.2 (high-risk score), the GIC rate was 14.3% (P < .001). In the low-risk group, the administration of antibiotic prophylaxis did not reduce the infectious complication rate, while in high-risk group the administration of antibiotic prophylaxis significantly reduced the rates of surgical site infection, GIC, and urinary infection by 72%, 67%, and 76.8%, respectively.
Conclusions |
This study demonstrates the efficacy of antibiotic prophylaxis in inguinal hernia surgery in the subgroup of high-risk patients.
Le texte complet de cet article est disponible en PDF.Keywords : Antibiotic prophylaxis, Inguinal hernia, Infectious morbidity, Multivariate analysis, Risk score
Plan
Vol 192 - N° 2
P. 165-171 - août 2006 Retour au numéro
Article précédent
- Therapeutic approach to tumors of the ampulla of Vater
- Akihiko Kobayashi, Masaru Konishi, Toshio Nakagohri, Shinichiro Takahashi, Taira Kinoshita
- The value of magnetic resonance imaging in diagnosis and size assessment of in situ and small invasive breast carcinoma
- Arjan P. Schouten van der Velden, Carla Boetes, Peter Bult, Theo Wobbes
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?