title: Predicting formation of adhesions after gynaecological surgery: development of a risk score.
abstract: OBJECTIVE
  Risk factors for post-surgical adhesions following gynaecological surgery have been identified, but their relative importance has not been precisely determined. No practical tool exists to help gynaecological surgeons evaluate the risk of adhesions in their patients. The purpose of the study was to develop an Adhesion Risk Score to provide a simple tool that will enable gynaecological surgeons to routinely quantify the risk of post-surgical adhesions in individual patients.
  
  
  METHODS
  A group of European gynaecological surgeons searched the literature to identify the risk factors and the surgical operations reported as carrying a risk of post-surgical adhesions. Through consensus process of meetings and communication, a four-point scale was then used by each surgeon to attribute a specific weight to each item and collective agreement reached on identified risk factors and their relative importance to allow construct of a useable risk score.
  
  
  RESULTS
  Ten preoperative and 10 intraoperative risk factors were identified and weighed, leading to the creation of two sub-scores to identify women at risk prior to and during surgery. The Preoperative Risk Score can range from 0 to 36, and the Intraoperative Risk Score from 3 to 31. Several thresholds between these limits may be used to identify women with low, medium, and high risk of post-surgical adhesions.
  
  
  CONCLUSIONS
  Gynaecological surgeons are encouraged to use this Adhesion Risk Score to identify the risk of adhesions in their patients. This will allow better informed use of available resources to target preventive measures in women at high risk of post-surgical adhesions.
authors.affiliation: Department of Gynaecology, Private Hospital Molholm, Vejle, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Lundorff
authors.forename: Hans
authors.initials: H
authors.lastname: Brölmann
authors.forename: Philippe Robert
authors.initials: PR
authors.lastname: Koninckx
authors.forename: Michal
authors.initials: M
authors.lastname: Mara
authors.forename: Arnaud
authors.initials: A
authors.lastname: Wattiez
authors.forename: Markus
authors.initials: M
authors.lastname: Wallwiener
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Trew
authors.forename: Alison M
authors.initials: AM
authors.lastname: Crowe
authors.forename: Rudy Leon
authors.initials: RL
authors.lastname: De Wilde
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D012307:Risk Factors; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*