title: The efficacy of risk scores for predicting abdominal wound dehiscence: a case-controlled validation study.
abstract: BACKGROUND
  The medical literature includes two risk scores predicting the occurrence of abdominal wound dehiscence. These risk indices were validated by the authors on the populations studied. However, whether these scoring systems can accurately predict, abdominal wound dehiscence in other populations remains unclear.
  
  
  METHODS
  A retrospective analysis was performed using the medical records of patients treated at a tertiary-care teaching hospital between 2008 and 2011. Patients that underwent laparotomy procedures complicated by the development of postoperative abdominal wound dehiscence were included into the study. For each of the cases, three controls were selected.
  
  
  RESULTS
  Among the 1,879 patients undergoing intra-abdominal, 56 patients developed wound dehiscence and 168 patients included in the control group. Calculation of risk scores for all patients, revealed significantly higher scores in the abdominal wound dehiscence group (p < 0.001). The median score was 24 (range: 3-46) and 4.95 (range: 2.2-7.8) vs.10 (range:-3-45) and 3.1 (range:0.4-6.9), for the Veterans Affairs Medical Center (VAMC) and Rotterdam abdominal wound dehiscence risk score in the dehiscence and control groups, respectively. The area under the curve, on the ROC plot, was 0.84 and 0.76; this confirmed a good and moderate predictive value for the risk scores. The fit of the model was good in both cases, as shown by the Hosmer and Lemeshow test.
  
  
  CONCLUSIONS
  Both the VAMC and Rotterdam scores can be used for the prediction of abdominal wound dehiscence. However, the VAMC prognostic score had better calibration and discriminative power when applied to the population in this study and taking into consideration our method of control selection.
authors.affiliation: 3rd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland. jkenig@cm-uj.krakow.pl.
authors.forename: Jakub
authors.initials: J
authors.lastname: Kenig
authors.forename: Piotr
authors.initials: P
authors.lastname: Richter
authors.forename: Anna
authors.initials: A
authors.lastname: Lasek
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zbierska
authors.forename: Sabina
authors.initials: S
authors.lastname: Zurawska
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D011044:Poland / Q000453:epidemiology; D011184:Postoperative Period; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000453:epidemiology*