van Ramshorst et al developed a model for predicting the risk of abdominal wound dehiscence in an adult. This can help to identify a patient who may benefit from more aggressive management. The authors are from Erasmus University Medical Center in Rotterdam, the Netherlands.
Patient selection: adult with a surgical abdominal incision, excluding routine appendectomies
Outcome: wound dehiscence
Parameters:
(1) age in years
(2) gender
(3) chronic pulmonary disease
(4) ascites
(5) jaundice
(6) anemia
(7) emergency surgery
(8) type of surgery
(9) coughing
(10) wound infection
|
Parameter |
Finding |
Points |
|
age in years |
< 40 years |
0 |
|
|
40 to 49 years |
0.4 |
|
|
50 to 59 years |
0.9 |
|
|
60 to 69 years |
0.9 |
|
|
>= 70 years |
1.1 |
|
gender |
female |
0 |
|
|
male |
0.7 |
|
chronic pulmonary disease |
no |
0 |
|
|
yes |
0.7 |
|
ascites |
absent |
0 |
|
|
present |
1.5 |
|
jaundice |
absent |
0 |
|
|
present |
0.5 |
|
anemia |
absent |
0 |
|
|
present |
0.7 |
|
emergency surgery |
no |
0 |
|
|
yes |
0.6 |
|
type of surgery |
gallbladder, bile duct |
0.7 |
|
|
esophagus |
1.5 |
|
|
gastroduodenal |
1.4 |
|
|
small bowel |
0.9 |
|
|
large bowel |
1.4 |
|
|
vascular |
1.3 |
|
|
other |
0 |
|
coughing |
absent |
0 |
|
|
present |
1.4 |
|
wound infection |
absent |
0 |
|
|
present |
1.9 |
where:
• Within each type of surgery there is a range of complexity.
• The other category included liver, kidney, pancreas, spleen and adrenal gland (page 22).
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum total score: 0
• maximum total score: 10.6
X =
= (1.085 * (total score)) - 8.37
probability of abdominal wound dehiscence =
= 1 / (1 + EXP((-1) * X))
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
