Comparison of Two Predictive Scores for the Development of Incisional Hernia

Edgard Efren Lozada Hernández; Miguel Agustín González Gonzalez; José Francisco Molina Rodríguez; Enrique Obregón Moreno; Aldo Edyair Jiménez Herevia; Martin Cano Rosas

doi:doi:10.11648/j.js.20190706.17

Comparison of Two Predictive Scores for the Development of Incisional Hernia

Edgard Efren Lozada Hernández, Miguel Agustín González Gonzalez, José Francisco Molina Rodríguez, Enrique Obregón Moreno, Aldo Edyair Jiménez Herevia, Martin Cano Rosas

Published in Journal of Surgery (Volume 7, Issue 6)

Received: 19 November 2019 Accepted: 29 November 2019 Published: 10 December 2019

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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.

Published in	Journal of Surgery (Volume 7, Issue 6)
DOI	10.11648/j.js.20190706.17
Page(s)	188-193
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Predictive Scores, Incisional Hernia, Hernia Project, Van Ramshorst Score

References

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[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.
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[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.
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Edgard Efren Lozada Hernández, Miguel Agustín González Gonzalez, José Francisco Molina Rodríguez, Enrique Obregón Moreno, Aldo Edyair Jiménez Herevia, et al. (2019). Comparison of Two Predictive Scores for the Development of Incisional Hernia. Journal of Surgery, 7(6), 188-193. https://doi.org/10.11648/j.js.20190706.17

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ACS Style

Edgard Efren Lozada Hernández; Miguel Agustín González Gonzalez; José Francisco Molina Rodríguez; Enrique Obregón Moreno; Aldo Edyair Jiménez Herevia, et al. Comparison of Two Predictive Scores for the Development of Incisional Hernia. J. Surg. 2019, 7(6), 188-193. doi: 10.11648/j.js.20190706.17

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AMA Style

Edgard Efren Lozada Hernández, Miguel Agustín González Gonzalez, José Francisco Molina Rodríguez, Enrique Obregón Moreno, Aldo Edyair Jiménez Herevia, et al. Comparison of Two Predictive Scores for the Development of Incisional Hernia. J Surg. 2019;7(6):188-193. doi: 10.11648/j.js.20190706.17

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@article{10.11648/j.js.20190706.17,
  author = {Edgard Efren Lozada Hernández and Miguel Agustín González Gonzalez and José Francisco Molina Rodríguez and Enrique Obregón Moreno and Aldo Edyair Jiménez Herevia and Martin Cano Rosas},
  title = {Comparison of Two Predictive Scores for the Development of Incisional Hernia},
  journal = {Journal of Surgery},
  volume = {7},
  number = {6},
  pages = {188-193},
  doi = {10.11648/j.js.20190706.17},
  url = {https://doi.org/10.11648/j.js.20190706.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190706.17},
  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.},
 year = {2019}
}

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TY  - JOUR
T1  - Comparison of Two Predictive Scores for the Development of Incisional Hernia
AU  - Edgard Efren Lozada Hernández
AU  - Miguel Agustín González Gonzalez
AU  - José Francisco Molina Rodríguez
AU  - Enrique Obregón Moreno
AU  - Aldo Edyair Jiménez Herevia
AU  - Martin Cano Rosas
Y1  - 2019/12/10
PY  - 2019
N1  - https://doi.org/10.11648/j.js.20190706.17
DO  - 10.11648/j.js.20190706.17
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 188
EP  - 193
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20190706.17
AB  - 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.
VL  - 7
IS  - 6
ER  -

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Author Information

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

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APA Style

Edgard Efren Lozada Hernández, Miguel Agustín González Gonzalez, José Francisco Molina Rodríguez, Enrique Obregón Moreno, Aldo Edyair Jiménez Herevia, et al. (2019). Comparison of Two Predictive Scores for the Development of Incisional Hernia. Journal of Surgery, 7(6), 188-193. https://doi.org/10.11648/j.js.20190706.17

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ACS Style

Edgard Efren Lozada Hernández; Miguel Agustín González Gonzalez; José Francisco Molina Rodríguez; Enrique Obregón Moreno; Aldo Edyair Jiménez Herevia, et al. Comparison of Two Predictive Scores for the Development of Incisional Hernia. J. Surg. 2019, 7(6), 188-193. doi: 10.11648/j.js.20190706.17

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AMA Style

Edgard Efren Lozada Hernández, Miguel Agustín González Gonzalez, José Francisco Molina Rodríguez, Enrique Obregón Moreno, Aldo Edyair Jiménez Herevia, et al. Comparison of Two Predictive Scores for the Development of Incisional Hernia. J Surg. 2019;7(6):188-193. doi: 10.11648/j.js.20190706.17

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@article{10.11648/j.js.20190706.17,
  author = {Edgard Efren Lozada Hernández and Miguel Agustín González Gonzalez and José Francisco Molina Rodríguez and Enrique Obregón Moreno and Aldo Edyair Jiménez Herevia and Martin Cano Rosas},
  title = {Comparison of Two Predictive Scores for the Development of Incisional Hernia},
  journal = {Journal of Surgery},
  volume = {7},
  number = {6},
  pages = {188-193},
  doi = {10.11648/j.js.20190706.17},
  url = {https://doi.org/10.11648/j.js.20190706.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190706.17},
  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.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Comparison of Two Predictive Scores for the Development of Incisional Hernia
AU  - Edgard Efren Lozada Hernández
AU  - Miguel Agustín González Gonzalez
AU  - José Francisco Molina Rodríguez
AU  - Enrique Obregón Moreno
AU  - Aldo Edyair Jiménez Herevia
AU  - Martin Cano Rosas
Y1  - 2019/12/10
PY  - 2019
N1  - https://doi.org/10.11648/j.js.20190706.17
DO  - 10.11648/j.js.20190706.17
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 188
EP  - 193
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20190706.17
AB  - 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.
VL  - 7
IS  - 6
ER  -

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