[Prognostic index in wound infection and abdominal sepsis].
OBJECTIVE
To establish an abdominal surgical infection prognostic index with all risk factors.


BACKGROUND
Individuals, requiring abdominal surgery have an established surgical infection risk of 1% and this risk increases with several factors, such as age over 50 years, (4%), diabetes mellitus (12%), obesity (8%), hospitalization up to 10 days (4%), bad nutrition (2%), surgical time up to 3 h (6%) summer (4%) shock (6%) immunosuppression (6%), contaminated surgery (from 1%-40%), or emergency surgery (4%).


METHODS
We reviewed 199 patients and investigated previous disease, total white blood cells, oxygen saturation, albumin, body weight, type of surgery performed in regard to contamination, surgical time, hospitalization time, preoperative hair removal previous to surgery, presence of emergency surgery, and prevalence of remote site infections at time of surgery. All these parameters were reviewed for 48 h before and after the surgical procedure and every risk factor acquired a number with respect to the established risk in the world literature. An index called Prognostic index of surgical infections (PISI) was performed, made up of the addition of risk factors. Every patient was observed 10 days after the surgical procedure searching for abdominal or wound infection and correlating the index with the presence of surgical infection.


RESULTS
Patients with a prognostic index of 12 or less did not show infections in any case; those with an index of 13 to 15 points had 30% of risk infection, 16 to 18 obtained 70%, 19 to 21 acquired 90%, and 22 or more obtained 100% of surgical risk infection. Sensitivity was 100% and specificity, nearby 75%.


CONCLUSIONS
PISI is a reliable indicator of surgical infection risk because it takes into account all factors that cause troubles in the patients, and has high sensitivity and very good specificity.
Chalita-Manzur
A
A
Departamento de Cirugía General, Centro Médico Nacional de Occidente, Guadalajara, Jalisco, México.
Hermosillo-Sandoval
J M
JM
D000005:Abdomen; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology*