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Development and Validation of a Scoring System to Predict Surgical Site Infection After Ventral Hernia Repair: A
Efstathios Karamanos1, Pridvi Kandagatla2, Jenna Watson2
1Department of General Surgery and the Department of Plastic and Reconstructive Surgery, Henry Ford Hospital/Wayne State University, 2799 W Grand Blvd, Detroit, MI, 48202, USA. ef.karamanos@gmail.com.
Introduction:
Surgical site infections (SSIs) are a rare but significant complication following an elective ventral hernia repair. This study aims to develop a risk assessment tool in order to predict the risk of developing SSIs postoperatively.
Methods:
All patients undergoing an elective ventral hernia repair were identified using the Michigan Surgical Quality Collaborative (MSQC) database. Patients' demographics, comorbidities and technical aspects of the operations were extracted. Logistic regressions were used to create a predictive scoring system for SSIs.
Results:
A total of 4983 were included. SSIs occurred in 3.4% of the patient population. A stepwise forward logistic regression identified the need to use drains, BMI, wound classification at the end of the surgery, presence of severe adhesions, a history of CAD, the need for intensive care after surgery, the use of pressors, EtOH abuse and history of PVD as being independently associated with the development of postoperative surgical site infections.
Conclusion:
In patients undergoing an elective hernia repair, the incidence of SSI is low. Several preoperative and perioperative factors can contribute to the development of SSIs.
Insights
Developing a risk assessment tool can help predict surgical site infections (SSIs) after elective ventral hernia repair. Key factors include BMI, wound classification, and patient comorbidities, aiding in SSI prevention.
Area of Science:
- Surgical outcomes research
- Infectious disease epidemiology
Background:
- Surgical site infections (SSIs) are infrequent but serious complications after elective ventral hernia repair.
- Predicting SSI risk is crucial for patient management and improving surgical outcomes.
Purpose of the Study:
- To develop a predictive risk assessment tool for SSIs following elective ventral hernia repair.
- To identify key preoperative and perioperative factors associated with SSI development.
Main Methods:
- Utilized the Michigan Surgical Quality Collaborative (MSQC) database to identify patients undergoing elective ventral hernia repair.
- Extracted patient demographics, comorbidities, and operative details.
- Employed logistic regression analysis to construct a predictive scoring system for SSIs.
Main Results:
- A total of 4983 patients were analyzed, with an SSI incidence of 3.4%.
- Independent predictors of SSIs included drain use, BMI, wound classification, severe adhesions, coronary artery disease (CAD), need for intensive care, pressor use, alcohol abuse, and peripheral vascular disease (PVD).
Conclusions:
- The incidence of SSIs after elective hernia repair is low.
- Several preoperative and perioperative factors significantly contribute to the risk of developing SSIs, informing the development of a predictive tool.
