Predictive risk score for infection after inguinal hernia repair.
Fiche publication
Date publication
août 2006
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PESSAUX Patrick
Tous les auteurs :
Pessaux P, Lermite E, Blezel E, Msika S, Hay JM, Flamant Y, Deepak V, Arnaud JP
Lien Pubmed
Résumé
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.
Référence
Am J Surg. 2006 Aug;192(2):165-71.