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2020, Number 4

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Rev Cub Med Mil 2020; 49 (4)

Validity of three procedures for predicting reoperation in abdominal surgery: a cohort study

Soler MCD, Tamargo BTO, Pérez MJC, Lombardo VTA, Illodo HOL

Language: Spanish
References: 31
Page:
PDF size: 361.44 Kb.


ABSTRACT

Introduction: It is difficult to diagnose with certainty the need to reoperate a patient after major abdominal surgery.
Objective: To assess the validity of three procedures for predicting reoperation in abdominal surgery.
Method: Explanatory, cohort, prospective study, from November 2016 to April 2017, 146 patients in postoperative period of major abdominal surgery, consecutively admitted to the intensive care unit of the Hospital “Carlos J Finlay”. To decide on reoperation, patients were evaluated according to clinical, laboratory and imaging criteria. Independently, the probability of requiring a reoperation was estimated using the Acute Re-intervention Predictive Index, the Abdominal Surgery Reoperation Prognosis Aid System and intra-abdominal pressure. To analyse their usefulness, the Receiver Operating Characteristic curve was applied and the best cut-off point with its validity indicators was selected.
Results: 23 patients (15.8%) were reoperated. The area under the receiver operator curve (AUC) of the three scores was above 0.8, with an excellent ability to discriminate between patients who really required reoperation and those who did not, but with significant differences between them (p <0.001). The Abdominal Surgery Reoperation Prognosis Aid System had the best performance, with an AUC = 0.965 (CI 0.933-0.997), followed by the intra-abdominal pressure (AUC = 0.939, CI 0.892-0.987) and the Acute Re-intervention Predictive Index (AUC = 0.863, CI 0.789-0.938).
Conclusions: The Abdominal Surgery Reoperation Prognosis Aid System shows an excellent performance and an efficiency superior to that demonstrated by the other two procedures, which makes it recommendable to predict the need to reoperate after major abdominal surgery.


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