• 作者：Carlos Javier G贸mez D铆az ; Pere Rebasa Cladera ; Salvador Navarro Soto ; Jos茅 Manuel Hidalgo Rosas ; Alexis Luna Aufroy ; S ; ra Montmany Vioque ; Constanza Corredera Cantar铆n
• 关键词：Evisceració ; n ; Factores de riesgo ; Modelo de riesgo ; Complicació ; n quirú ; rgica
• 刊名：Cirugía Espa?ola
• 出版年：February, 2014
• 年：2014
• 卷：92
• 期：2
• 页码：114-119
• 全文大小：396 K

Introduction

The aim of this study is to determine the usefulness of the risk model developed by van Ramshorst et al., and a modification of the same, to predict the abdominal wound dehiscence's risk in patients who underwent midline laparotomy incisions.

Materials and methods

Observational longitudinal retrospective study. Sample: Patients who underwent midline laparotomy incisions in the General and Digestive Surgery Department of the Sabadell's Hospital-Parc Taul铆鈥檚 Health and University Corporation-Barcelona, between January 1, 2010 and June 30, 2010. Dependent variable: Abdominal wound dehiscence. Independent variables: Global risk score, preoperative risk score (postoperative variables were excluded), global and preoperative probabilities of developing abdominal wound dehiscence.

Results

Sample: 176 patients. Patients with abdominal wound dehiscence: 15 (8.5%). The global risk score of abdominal wound dehiscence group (mean: 4.97; IC 95%: 4.15-5.79) was better than the global risk score of No abdominal wound dehiscence group (mean: 3.41; IC 95%: 3.20-3.62). This difference is statistically significant (P<.001). The preoperative risk score of abdominal wound dehiscence group (mean: 3.27; IC 95%: 2.69-3.84) was better than the preoperative risk score of No abdominal wound dehiscence group (mean: 2.77; IC 95%: 2.64-2.89), also a statistically significant difference (P<.05). The global risk score (area under the ROC curve: 0.79) has better accuracy than the preoperative risk score (area under the ROC curve: 0.64).

Conclusion

The risk model developed by van Ramshorst et al. to predict the abdominal wound dehiscence's risk in the preoperative phase has a limited usefulness. Additional refinements in the preoperative risk score are needed to improve its accuracy.