Predictive risk score for infection after inguinal hernia repair.

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 x age > or =75 years) + (1.1 obesity) + (2.1 x 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.

• Authors: Patrick Pessaux, Emilie Lermite, Eric Blezel, Simon Msika, Jean-Marie Hay, Yves Flamant, Varma Deepak, Jean-Pierre Arnaud, French Associations for Surgical Research
• Journal: American journal of surgery (Am J Surg) Vol. 192 Issue 2 Pg. 165-71 (Aug 2006) ISSN: 0002-9610 [Print] United States
• PMID: 16860624 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adolescent
• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Antibiotic Prophylaxis
• France (epidemiology)
• Hernia, Inguinal (surgery)
• Humans
• Incidence
• Male
• Middle Aged
• Multicenter Studies as Topic
• Prognosis
• ROC Curve
• Randomized Controlled Trials as Topic
• Risk Factors
• Surgical Wound Infection (epidemiology, prevention & control)