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2021, Number 2

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Revista Cubana de Cirugía 2021; 60 (2)

A predictive scale for dehiscence of the Intestinal suture line

Fonseca SFK, Rey VYS, Ramos SAE, Llópiz PRS, Araluce RRA, León FML

Language: Spanish
References: 16
Page: 1-15
PDF size: 456.45 Kb.


ABSTRACT

Introduction: The suture line dehiscence is one of the most frequent complications in intestinal surgery.
Objective: To design a predictive scale for estimating individual probability of suture line dehiscence.
Methods: An analytical cohort study, which involved retrospective data collection, was carried out, in the six-year period of 2014-2019, at Celia Sánchez Manduley Hospital. The sample consisted of 437 patients. Dehiscence of the intestinal suture line was used as a dependent variable, while age, sex, comorbidity, hemoglobin, hypoalbuminemia, colon neoplasia, anesthetic risk, among others, were used as independent variables.
Results: Through multivariate analysis, an adjusted model was obtained, with the following results for the variables: age over 70 years (P=0.002), hypoalbuminemia (P=0.014), enterocolic anastomosis (P=0.018), urgent surgery (P=0.001), and ileus prolonged paralytic (P<0.001). The predictive scale was derived from the adjusted statistical model and, based on the probability of dehiscence of the intestinal suture line, classified into three risk groups: low (less than two points), moderate (between 3-5 points) and high (more than six points). It presented a sensitivity of 89.6%, a specificity of 89.1%, a global predictive percentage of 89.2%, a positive predictive value of 66.1%, and a negative predictive value of 97.2%. It had an excellent calibration and a high discriminative power.
Conclusion: A predictive scale was obtained for estimating the individual probability of dehiscence of the intestinal suture line.


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