Abstract
BackgroundThe medical literature includes two risk scores predicting the occurrence of abdominal wound dehiscence. These risk indices were validated by the authors on the populations studied. However, whether these scoring systems can accurately predict, abdominal wound dehiscence in other populations remains unclear.MethodsA retrospective analysis was performed using the medical records of patients treated at a tertiary-care teaching hospital between 2008 and 2011. Patients that underwent laparotomy procedures complicated by the development of postoperative abdominal wound dehiscence were included into the study. For each of the cases, three controls were selected.ResultsAmong the 1,879 patients undergoing intra-abdominal, 56 patients developed wound dehiscence and 168 patients included in the control group. Calculation of risk scores for all patients, revealed significantly higher scores in the abdominal wound dehiscence group (p < 0.001). The median score was 24 (range: 3–46) and 4.95 (range: 2.2-7.8) vs.10 (range:-3-45) and 3.1 (range:0.4-6.9), for the Veterans Affairs Medical Center (VAMC) and Rotterdam abdominal wound dehiscence risk score in the dehiscence and control groups, respectively. The area under the curve, on the ROC plot, was 0.84 and 0.76; this confirmed a good and moderate predictive value for the risk scores. The fit of the model was good in both cases, as shown by the Hosmer and Lemeshow test.ConclusionsBoth the VAMC and Rotterdam scores can be used for the prediction of abdominal wound dehiscence. However, the VAMC prognostic score had better calibration and discriminative power when applied to the population in this study and taking into consideration our method of control selection.
Highlights
The medical literature includes two risk scores predicting the occurrence of abdominal wound dehiscence
Abdominal wound dehiscence is one of the most serious postoperative complications; the incidence in the adult population is reported as 0.3-3.5%, and among the elderly it is as high as 10%
In about 20-45% of cases, evisceration becomes a significant risk factor, which is associated with death during the perioperative period [1,2]
Summary
The medical literature includes two risk scores predicting the occurrence of abdominal wound dehiscence. These risk indices were validated by the authors on the populations studied. Whether these scoring systems can accurately predict, abdominal wound dehiscence in other populations remains unclear. Abdominal wound dehiscence is one of the most serious postoperative complications; the incidence in the adult population is reported as 0.3-3.5%, and among the elderly it is as high as 10%. In about 20-45% of cases, evisceration becomes a significant risk factor, which is associated with death during the perioperative period [1,2]. Several publications have indentified risk factors associated with this complication; many of the reports have conflicting results. By van Ramshorst GH et al in 2010 and Webster C et al in 2003, reported on a scoring
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