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Risk Score for Infection Following Inguinal Hernia Repair

Purpose: To evaluate a patient prior to an inguinal hernia repair for risk factors associated with postoperative nosocomial infections as reported by Pessaux et al.

Description

Pessaux et al identified risk factors for nosocomial infections in patients undergoing inguinal hernia repair. This can help to identify a patient who may benefit from more aggressive management. The authors are from Universitaire Angersand the French Association for Surgical Research.


The outcome was "global infection", which entailed surgical site infections (SSI), urinary tract infections and any other nosocomial infection.

 

Parameters:

(1) age in years

(2) obesity based on body mass index (BMI)

(3) urinary catheter

 

Parameter

Finding

Points

age of the patient

< 75 years

0

 

>= 75 years

1

obesity

BMI < 30 kg per square m

0

 

BMI >= 30 kg per square m

1

urinary catheter

absent

0

 

present

1

 

risk score =

= (0.95 * (points for age)) + (1.1 * (points for obesity)) + (2.1 * (points for urinary catheter)) - 4.7

 

Interpretation:

• minimum score: -4.7

• maximum score: -0.55

• A score < -4.2 was considered low risk. A score >= -4.2 was considered high risk.

• Administration of antibiotic prophylaxis benefited high risk patients but not low risk patients.

 

Limitations:

• The cutoff of -4.2 cannot be achieved by any combination of findings.

• Basically the equation is of limited benefit since the same effect can be achieved by saying that a low risk patient has no risk factors while a high risk patient has at least 1.


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Specialty

Objective

ICD-10