Volume 7, Issue 6, December 2019, Page: 188-193
Comparison of Two Predictive Scores for the Development of Incisional Hernia
Edgard Efren Lozada Hernández, Surgery Department and Clinical Research, Regional Hospital of High Specialty Bajio, Leon Guanajuato, Mexico
Miguel Agustín González Gonzalez, Surgery Department, General Hospital of Calvillo, Aguascalientes, Mexico
José Francisco Molina Rodríguez, Surgery Department, Juarez Hospital of Mexico, Mexico City, Mexico
Enrique Obregón Moreno, Surgery Department, Regional Hospital of High Specialty Bajio, Leon Guanajuato, Mexico
Aldo Edyair Jiménez Herevia, Surgery Department, Regional Hospital of High Specialty Bajio, Leon Guanajuato, Mexico
Martin Cano Rosas, Surgery Department, Regional Hospital of High Specialty Bajio, Leon Guanajuato, Mexico
Received: Nov. 19, 2019;       Accepted: Nov. 29, 2019;       Published: Dec. 10, 2019
DOI: 10.11648/j.js.20190706.17      View  100      Downloads  87
Abstract
Introduction: Incisional Hernia (IH) is a frequent complication of abdominal surgery, with an incidence of 10-23%, which can increase to 38% in specific risk groups. So far there is no ideal method to identify patients at high risk of developing IH, this variety in the criteria of inclusion of patients in different studies makes is very complicate to compare the results. The aim of this study is comparing the two predictive scores of incisional hernias (Hernia project Vs Van Ramshorst) with higher diagnostic performance and determine which is better to predict IH. Methods: An analytical, observational study was conducted between June and December 2018, in patients of both sexes, who were 18 years or older, undergoing midline laparotomy, regardless of their background diagnosis either urgently or scheduled between 2007 to 2016. The two different classifications, the Hernia Project score and Van Ramshorst score, were applied to each of the patients. With the identification of patients with hernia, two groups, healthy and ill, were performed and Bayesian statistics were made with it and to identify which scale best predicts the presence of this complication. Results: The records of 1085 patients undergoing midline laparotomy were reviewed. 296 patients were ruled out because their follow-up was not complete. Both tests were compared to determine the best diagnostic performance using the ROC curve and the area under the curve, finding that the Hernia Project Score has a larger area 0.724 compared to a 0.663 of Van Ramshorst. Discussion: In our patient cohort, the Hernia Project score has a greater predictive capacity, with an area under the best curve (0.72 vs. 0.66) however both They have a poor sensitivity and this is the main measure of the predictive capacity of any diagnostic test, so with these results, we can affirm that the Project hernia scale has a greater diagnostic capacity than the Van Ramshorst scale but still its diagnostic capacity is limited. Conclusions: Both scores have low sensitivity. We can affirm that the Hernia Project score has a greater diagnostic capacity than the Van Ramshorst score, but both have a limited diagnostic capacity.
Keywords
Predictive Scores, Incisional Hernia, Hernia Project, Van Ramshorst Score
To cite this article
Edgard Efren Lozada Hernández, Miguel Agustín González Gonzalez, José Francisco Molina Rodríguez, Enrique Obregón Moreno, Aldo Edyair Jiménez Herevia, Martin Cano Rosas, Comparison of Two Predictive Scores for the Development of Incisional Hernia, Journal of Surgery. Vol. 7, No. 6, 2019, pp. 188-193. doi: 10.11648/j.js.20190706.17
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Deerenberg EB, Harlaar JJ, Steyerberg EW, et al. Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicenter, randomized controlled trial. Lancet 2015; 386: 1254-1260.
[2]
Jairam AP, Timmermans L, Eker HH, et al. PRIMA Trialist group. Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement versus primary suture only in midline laparotomies (PRIMA): 2-years follow-up of a multicenter, double blind, randomized controlled trial. Lancet. 2017; 390 (10094): 567-576. doi: 10.1016/S0140-6736(17) 31332-6.
[3]
H. W. Harris et al., Contemporary concepts in hernia prevention: selected proceedings from the 2017 international simposium of prevention of Incisional Hernia. Surgery 2018. http://doi.org/10.1016/j.surg.2018.02.020.
[4]
Kohler A, Lavanchy JL, Lenoir U, Kurmann A, Candinas D, Beldi G. Effectiveness of prophylactic intraperitoneal mesh implantation for prevention of incisional hernia in patients undergoing open abdominal surgery A Randomized Clinical Trial. JAMA surgery 2019. 154 (2): 109-115.
[5]
Caro-Tarrago A, Olona C, Millan M, Olona M, Espina B, Jorba R. Long-term results of a prospectiv randomized trial of midline laparotomy closure with onlay mesh. Hernia (2019) 23: 335-340.
[6]
Hernandez-Granados P, Lopez-Cano M, Morales-Conde S, Muysoms F, Garcia-Alamino J, Pereira-Rodriguez JA. Profilaxis de la hernia incisional y utilización de mallas. Revision Narrativa. Cir Esp 2018; 96 (2): 76-87.
[7]
Glauser PM, Brosi P, Speich B, Käser SA, Heigl A, et al. Prophylactic intraperitoneal onlay mesh following midline laparotomy-Long-term Results of a Randomized Controlled Trial. World J Surg 2019; 43 (7): 1669-1675. Doi: 10.1007/s00268-019-04964-6.
[8]
San Miguel C, Melero D, Jimenez E, Lopez P et al. Long-term outcomes after prophylactic use of onlay mesh in midline laparotomy. Hernia (2018); 22: 1113-1122. doi: http://doi.org/10.1007/s10029-018-1833-x.
[9]
Payne R, Aldwinckle J, Ward S. Meta-analysis of randomized trials comparing the use of prophylactic mesh to standard midline closure in the reduction of incisional herniae. Hernia 2017. 21: 843-853.
[10]
Lozada-Hernandez EE, Mayagoitia-Gonzalez JC, Smolinski-Kurek R, Alvarez-Canales JJ, Montiel-Hinojosa L et al. Comparación de dos técnicas de sutura para cierre aponeurotico en laparotomía media en pacientes con alto riesgo de evisceración posquirúrgica. Rev Hispanoam Hernia. 2016; 4 (4): 137-143.
[11]
Van Ramshorst GH, Nieuwenhuizen J, Jop WC, Arends P, Boom J et al. abdominal wound dehiscence in adults: development and validation of a risk model. World J surg. 2010; 34: 20-7.
[12]
Webster C, Neumayer L, Smout R, Horn S, Daley J et al. Prognostic models of abdominal wound dehiscence after laparotomy. Journal of surgical Research (2003); 109: 130-137. doi: 10.1006/jsre.2003.660.
[13]
Veljkovik R, Protic M, Gluhovic A, Potic Z, Milosevic A et al. Prospective clinical trial of factors predicting the early development of incisional hernia after midline laparotomy. J Am Coll Surg 2010; 210: 201-219.
[14]
Gómez-Diaz CJ, Rebasa-Cladera P, Navarro-Soto S, Hidalgo-Rosas JM, Luna Aufory A et al. Validación de un modelo de riesgo de evisceración. Cir Esp. 2014; 92 (2): 114-119.
[15]
Goodenough CJ, Ko CT, Kao LS, Nguyen MT, Holihan Jl et al. Development and validation of a risk stratification score for ventral hernia after abdominal surgery: Hernia expectation rates in intra-abdominal surgery (The HERNIA Project). J Am Coll Surg 2015; 220: 405-413.
[16]
Cherla DP, Moses ML, Muek KM, Hannon C, Ko CT et al. External validation of the HERNIA score: an observational study. J Am Coll Surg 2017; 225: 428-434.
[17]
Fischer JP, Basta MN, Mirzabeigi MN, Bauder AR, Fox JP, Drebin JA, et al. A risk model and cost analysis of incisional hernia after elective abdominal surgery based upon 12373 cases: the case for targeted prophylactic intervention. Ann Surg 2016; 263: 1010-1017.
Browse journals by subject