Predictive risk score for infection after inguinal hernia repair
Predictive risk score for infection after inguinal hernia repair
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DOI：
10.1016/j.amjsurg.2006.05.003
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发表时间：
2006-08-01
影响因子：
3
通讯作者：
Arnaud, Jean-Pierre
中科院分区：
文献类型：
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作者：
Pessaux, Patrick;Lermite, Emilie;Arnaud, Jean-Pierre
背景：确定腹股沟疝修补术后全球感染并发症(GIC)的高危和低危亚组。方法：根据3个前瞻性多中心随机试验，建立了1254例腹股沟疝修补术患者的数据库(A组)。结果：建立了GIC的危险评分：-4.7+(0.95x年龄=75岁)+(1：1肥胖)+(2.1x尿管)。FISK评分低于-4.2分(低FISK组)，GIC发生率为2.7%；高于-4.2分(高危评分)，GIC发生率为14.3%(P<；.001)。在低风险组中，预防性应用抗生素并不能降低感染并发症的发生率，而在高危组中，预防性应用抗生素显著降低了手术部位感染、GIC和尿路感染的发生率，降低了72%。分别为67%和76.8%。结论：本研究证实了在高危人群腹股沟疝修补术中使用抗生素预防的有效性。(C)2006 Excerpta Medica Inc.保留所有权利。
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 13).Results: A risk score for GIC was constructed: -4.7 + (0.95 x age >= 75 years) + (1:1 obesity) + (2.1 x urinary catheter). In case of score less than -4.2 (low-fisk 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. (c) 2006 Excerpta Medica Inc. All rights reserved.