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Predictive risk score for infection after inguinal hernia repair
Patrick Pessaux1, Emilie Lermite, Eric Blezel
1Service de Chirurgie Digestive, Centre Hospitalier et Universitaire Angers, France. pessauxpchuangers@yahoo.fr
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.