Validation of Abdominal Wound Dehiscence's Risk Model

Abstract

IntroductionThe 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 methodsObservational longitudinal retrospective study. Sample: Patients who underwent midline laparotomy incisions in the General and Digestive Surgery Department of the Sabadell's Hospital – Parc Taulí’s 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. ResultsSample: 176 patients. Patients with abdominal wound dehiscence: 15 (8.5%). The global risk score of abdominal wound dehiscence group (mean: 4.97; CI 95%: 4.15–5.79) was better than the global risk score of No abdominal wound dehiscence group (mean: 3.41; CI 95%: 3.20–3.62). This difference is statistically significant (P<.001). The preoperative risk score of abdominal wound dehiscence group (mean: 3.27; CI 95%: 2.69–3.84) was better than the preoperative risk score of No abdominal wound dehiscence group (mean: 2.77; CI 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). ConclusionThe 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.