title: Predictive risk score for infection after inguinal hernia repair.
abstract: BACKGROUND
  Identification of subgroups of patients at high and low risk for global infectious complications (GIC) after inguinal hernia repair without mesh.
  
  
  METHODS
  A database of 1254 patients who underwent inguinal hernia repair without mesh, issued from 3 prospective multicenter randomized trials, has been established (group A). After multivariate analysis, a score for GIC was calculated and tested using data from a similar prospective randomized multicenter study (group B).
  
  
  RESULTS
  A risk score for GIC was constructed: -4.7 + (0.95 x age > or =75 years) + (1.1 obesity) + (2.1 x urinary catheter). In case of score less than -4.2 (low-risk group), the GIC rate was 2.7%; therefore, in case of score more than -4.2 (high-risk score), the GIC rate was 14.3% (P < .001). In the low-risk group, the administration of antibiotic prophylaxis did not reduce the infectious complication rate, while in high-risk group the administration of antibiotic prophylaxis significantly reduced the rates of surgical site infection, GIC, and urinary infection by 72%, 67%, and 76.8%, respectively.
  
  
  CONCLUSIONS
  This study demonstrates the efficacy of antibiotic prophylaxis in inguinal hernia surgery in the subgroup of high-risk patients.
authors.affiliation: Service de Chirurgie Digestive, Centre Hospitalier et Universitaire Angers, France. pessauxpchuangers@yahoo.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Emilie
authors.initials: E
authors.lastname: Lermite
authors.forename: Eric
authors.initials: E
authors.lastname: Blezel
authors.forename: Simon
authors.initials: S
authors.lastname: Msika
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Hay
authors.forename: Yves
authors.initials: Y
authors.lastname: Flamant
authors.forename: Varma
authors.initials: V
authors.lastname: Deepak
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Arnaud
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D005602:France / Q000453:epidemiology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011379:Prognosis; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents